Provider Demographics
NPI:1275793051
Name:PICKETT, CAROLE RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:RENEE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 CAPLES RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-8981
Mailing Address - Country:US
Mailing Address - Phone:318-327-7543
Mailing Address - Fax:
Practice Address - Street 1:2351 VANDENBURG DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-5609
Practice Address - Country:US
Practice Address - Phone:318-483-7341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA183721835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy