Peterson, Connie Marie

Peterson, Connie Marie is an individual health care provider with primary practice located at 2351 Vandenburg Dr , Alexandria LA 71303-5609. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Peterson, Connie Marie can be contacted via phone (318) 483-7336.

Contact Information

Primary practice address
2351 Vandenburg Dr Alexandria LA 71303-5609
Fax: (318) 483-7088
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 13816 Louisiana

Profile Details

NPI number 1831190131
LBN Legal business name Peterson, Connie Marie
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831190131 NPPES
Louisiana Other 13816 BOARD OF PHARMACY

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