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NPI Code Detail

MEDICARE: ANNE WELDON RD, LDN, CDE

MEDICARE: ANNE WELDON RD, LDN, CDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian142LA

General Provider Information

NPI Number : 1093327041
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE WELDON RD, LDN, CDE
Provider Business Mailing Address
First Line : PO BOX 1636
Second Line :
City : MANSFIELD
State : LA
Zip : 71052-1636
Country : US
Telephone Number : 318-871-3101
Fax Number : 318-872-6134
Provider Business Practice Location Address
First Line : 207 JEFFERSON ST
Second Line :
City : MANSFIELD
State : LA
Zip : 71052-2603
Country : US
Telephone Number : 318-872-4610
Fax Number : 318-872-6134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2020
Last Update Date : 08/20/2020

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