Individual
AMANDA JOHNSON OUBRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
5349 CYPRESS ST, WEST MONROE, LA 71291-7505
(504) 275-8233
Mailing address
12 BRIDLE PATH LN, SAINT ROSE, LA 70087-3658
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.022288
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PST.022288
PHARMACIST LICENSE NUMBER
LA
Enumeration date
12/12/2017
Last updated
12/12/2017
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