Provider Demographics
NPI:1457666547
Name:GILLARD, ROCHELLE R
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:R
Last Name:GILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5947
Mailing Address - Country:US
Mailing Address - Phone:504-483-2486
Mailing Address - Fax:504-483-8862
Practice Address - Street 1:4420 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5947
Practice Address - Country:US
Practice Address - Phone:504-483-2486
Practice Address - Fax:504-483-8862
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA15386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist