MEDICARE: KRISTIN WEST RD LDN

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	133V00000X	Registered Dietitian	2452	LA

General Provider Information

NPI Number	:	1831443845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN WEST RD LDN

Provider Business Mailing Address
First Line	:	8490 PICARDY AVE BLDG 600-D
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-819-1175
Fax Number	:

Provider Business Practice Location Address
First Line	:	8490 PICARDY AVE BLDG 600-D
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-819-1175
Fax Number	:

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

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	03/18/2015

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