MEDICARE: LEIGH ANNE GEISLER BURNS RD

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
1	133N00000X	Nutritionist	780	LA

General Provider Information

NPI Number	:	1356352876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH ANNE GEISLER BURNS RD

Provider Business Mailing Address
First Line	:	1340 POYDRAS ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-1221
Country	:	US
Telephone Number	:	504-412-1860
Fax Number	:

Provider Business Practice Location Address
First Line	:	2025 GRAVIER ST
Second Line	:	SUITE 613
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2260
Country	:	US
Telephone Number	:	504-412-1860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	06/26/2014

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