Laura Ann Ivy LDN RD

NPI 1063480366 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1063480366
Gender Female
Enumeration Date 03/10/2006
Last Updated 07/12/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
510 E STONER AVE
SHREVEPORT LA, 71101-4243, US
Phone (318) 221-8411
Fax (318) 429-5724
Business Location
4111 PINES RD
SHREVEPORT LA, 71119-7315, US
Phone (318) 631-4109
Fax
Toxanomy
Taxonomy Code 133V00000X
License State Louisiana
License Number 884597
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According to our database, Laura Ann Ivy LDN RD NPI is 1063480366, taxonomy code is 133V00000X and license number is 884597, license state is located at Louisiana. Laura Ann Ivy LDN RD physically located at 510 E Stoner Ave, Shreveport LA, 71101-4243. NPI Number Laura Ann Ivy LDN RD has the Individual type.

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1063480366 NPI number is provided on an as is basis without warranty of any kind. 1063480366 is maintained by the National Plan & Provider Enumeration System. The contents of Laura Ann Ivy LDN RD are for informational purposes only.