Lanie Renee Boullion

Individual provider Active NPI Registered Dietitian · Kaplan, LA

NPI 1447081773 · NPPES record last updated Aug 8, 2024

Key facts

NPI
1447081773
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
3197 (LA)
Practice address
16733 W la Hwy 700
Kaplan, LA 70548-6454
Phone
(337) 652-1669
NPI assigned
Aug 8, 2024
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
3197LAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3197 LA Yes

Addresses

Primary practice location

16733 W la Hwy 700
Kaplan, LA 70548-6454

Mailing address

16733 W la Hwy 700
Kaplan, LA 70548-6454
Phone (337) 652-1669

Other providers in Kaplan, LA

All providers in Kaplan, LA · Registered Dietitian in Louisiana

Sources for this page

Verify at the official NPI Registry.