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NPI Code Detail

MEDICARE: HANNAH CELESTE RIDEAUX MS, RDN, LDN

MEDICARE: HANNAH CELESTE RIDEAUX MS, RDN, 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1861121733
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH CELESTE RIDEAUX MS, RDN, LDN
Provider Business Mailing Address
First Line : 201 W GIBBS LN
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560-7231
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2390 W CONGRESS ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-4205
Country : US
Telephone Number : 337-261-6113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2022
Last Update Date : 06/07/2022

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