Provider Demographics
NPI:1972902849
Name:STELLY, LUCINDA M (RPH)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:M
Last Name:STELLY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:M
Other - Last Name:STELLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:525 N CITIES SERVICE HWY
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-4107
Mailing Address - Country:US
Mailing Address - Phone:337-625-7057
Mailing Address - Fax:
Practice Address - Street 1:525 N CITIES SERVICE HWY
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-4107
Practice Address - Country:US
Practice Address - Phone:337-625-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist