Provider Demographics
NPI:1528686086
Name:VO, NINA L (RPH)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:L
Last Name:VO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 BELLEMEADE BLVD
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7631
Mailing Address - Country:US
Mailing Address - Phone:504-638-4263
Mailing Address - Fax:
Practice Address - Street 1:5360 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-6548
Practice Address - Country:US
Practice Address - Phone:225-757-1023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist