Provider Demographics
NPI:1285744375
Name:DOUCETTE, MICHELLE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 AMAZON ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6401
Mailing Address - Country:US
Mailing Address - Phone:504-813-2025
Mailing Address - Fax:504-309-9460
Practice Address - Street 1:3001 HIGHWAY 90 W
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:LA
Practice Address - Zip Code:70094-2758
Practice Address - Country:US
Practice Address - Phone:504-437-0650
Practice Address - Fax:504-437-0541
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1262803Medicaid