Individual
VANESSA LYNETTE MICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1718 N FOSTER DR STE B, BATON ROUGE, LA 70806-1076
(225) 465-3669
(225) 465-3687
Mailing address
7778 EMILE ST, BATON ROUGE, LA 70807-5633
(404) 245-8839
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST020614
LA
Other
Enumeration date
03/10/2015
Last updated
03/29/2024
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