Provider Demographics
NPI:1356656326
Name:MICHELLI, JENNIFER H (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:H
Last Name:MICHELLI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14444 COURSEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-1319
Mailing Address - Country:US
Mailing Address - Phone:225-753-1499
Mailing Address - Fax:225-753-2682
Practice Address - Street 1:14444 COURSEY BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-1319
Practice Address - Country:US
Practice Address - Phone:225-753-1499
Practice Address - Fax:225-753-2682
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist