| Mrs Glenda Poche Vicknair, CRNA | |
|
2471 Louisiana Ave, St James Parish Hospital, Lutcher, LA 70071-5413 | |
| (225) 869-5512 | |
| (225) 869-4956 |
| Full Name | Mrs Glenda Poche Vicknair |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 2471 Louisiana Ave, Lutcher, Louisiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588646160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN027658 (Louisiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 021000 (Louisiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Glenda Poche Vicknair, CRNA 316 N Millet Ave, Gramercy, LA 70052-3610 Ph: (225) 869-8668 | Mrs Glenda Poche Vicknair, CRNA 2471 Louisiana Ave, St James Parish Hospital, Lutcher, LA 70071-5413 Ph: (225) 869-5512 |