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1487188256
ALICIA FAULK NICKLAS
LAFAYETTE, LA
NPI
1487188256
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: LA AP09172)
Enumeration Date
2017-04-18
Last Update Date
2018-09-26
Business Address
ALICIA FAULK NICKLAS NP
104 GENEVIEVE DR
LAFAYETTE, LA 70503-4811
Phone number: 337-984-0110
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Mailing Address
ALICIA FAULK NICKLAS NP
104 GENEVIEVE DR
LAFAYETTE, LA 70503-4811
Phone number: 337-984-0110
Copy
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