Jill Ballard, R.D.,L.D.N.

Individual provider Active NPI Registered Dietitian · Livingston, LA

NPI 1487066007 · NPPES record last updated Jun 2, 2014

Key facts

NPI
1487066007
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2385 (LA)
Practice address
18811 La Highway 42
Livingston, LA 70754-4039
Phone
(225) 571-2126
Fax
(225) 686-1782
NPI assigned
Jun 2, 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
2385LAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2385 LA Yes

Addresses

Primary practice location

18811 La Highway 42
Livingston, LA 70754-4039

Mailing address

18811 La Highway 42
Livingston, LA 70754-4039
Phone (225) 571-2126

Other providers in Livingston, LA

All providers in Livingston, LA · Registered Dietitian in Louisiana

Sources for this page

Verify at the official NPI Registry.