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General NPI Number Information
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NPI Number | 1275793051
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Entity Type | Individual
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Provider Name | CAROLE RENEE PICKETT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2008
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Last Update Date | 06/14/2008
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Provider Practice Location Address
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Address Line | 2351 VANDENBURG DR
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City | ALEXANDRIA
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State | LA
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Zip | 71303-5609
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Country | US
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Telephone | 318-483-7341
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Fax |
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Provider Business Mailing Address
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Address Line | 620 CAPLES RD
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City | WEST MONROE
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State | LA
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Zip | 71292-8981
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Country | US
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Telephone | 318-327-7543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 18372
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License Number State | LA
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