Provider Demographics
NPI:1043659766
Name:VIDRINE, LEIGH ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:VIDRINE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ABALON CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-1376
Mailing Address - Country:US
Mailing Address - Phone:337-344-6401
Mailing Address - Fax:
Practice Address - Street 1:3500 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-8229
Practice Address - Country:US
Practice Address - Phone:504-367-5724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-15
Last Update Date:2013-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.020155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist