Provider Demographics
NPI:1396044897
Name:MICHOT, PAULA LYNETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:LYNETTE
Last Name:MICHOT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:LYNETTE
Other - Last Name:CANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:236 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-3052
Mailing Address - Country:US
Mailing Address - Phone:318-240-7149
Mailing Address - Fax:318-240-7437
Practice Address - Street 1:236 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-3052
Practice Address - Country:US
Practice Address - Phone:318-240-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08113183500000X
LA18113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist