Jan W Johnson, RDN, LDN

Individual provider Active NPI Registered Dietitian · Lafitte, LA

NPI 1326467622 · NPPES record last updated Apr 15, 2014

Key facts

NPI
1326467622
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
143 (LA)
Practice address
5278 Church St
Lafitte, LA 70067-5224
Phone
(504) 451-0998
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
143LAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 143 LA Yes

Addresses

Primary practice location

5278 Church St
Lafitte, LA 70067-5224

Mailing address

5278 Church St
Lafitte, LA 70067-5224
Phone (504) 451-0998

Other providers in Lafitte, LA

All providers in Lafitte, LA · Registered Dietitian in Louisiana

Sources for this page

Verify at the official NPI Registry.