Individual
DR. GENA LAGRANGE NICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
1544 MANHATTAN BLVD, HARVEY, LA 70058-3406
(504) 362-7780
(504) 368-9351
Mailing address
1544 MANHATTAN BLVD, HARVEY, LA 70058-3406
(504) 362-7780
(504) 368-9351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17281
LA
Other
Enumeration date
08/14/2010
Last updated
08/14/2010
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