Provider Demographics
NPI:1922866748
Name:MCMILLON, CHELSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:MCMILLON
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 1:746 BIENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2016
Mailing Address - Country:US
Mailing Address - Phone:504-312-8435
Mailing Address - Fax:
Practice Address - Street 1:4100 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2203
Practice Address - Country:US
Practice Address - Phone:504-463-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.025194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist