Provider Demographics
NPI:1457084063
Name:MILLER, SHELLEY GUIDRY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:GUIDRY
Last Name:MILLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-3312
Mailing Address - Country:US
Mailing Address - Phone:337-873-7575
Mailing Address - Fax:
Practice Address - Street 1:7515 CAMERON ST
Practice Address - Street 2:
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529-3312
Practice Address - Country:US
Practice Address - Phone:337-873-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST016319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist