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Individual

IRIANNE NICHOLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
1201 SOUTH CLEARVIEW PARKWAY, JEFFERSON, LA 70121
(504) 715-3743
Mailing address
750 BELLEMEADE BLVD, GRETNA, LA 70056

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
11/27/2018
Last updated
11/27/2018
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