Healthcare Provider Details

I. General information

NPI: 1760217533
Provider Name (Legal Business Name): LINZAY LYLES CHATELAIN MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINZAY ELIZABETH LYLES

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 PICARDY AVE
BATON ROUGE LA
70809-3748
US

IV. Provider business mailing address

5215 ESSEN LN STE 200
BATON ROUGE LA
70809-3543
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-7000
  • Fax: 225-215-1380
Mailing address:
  • Phone: 225-767-0847
  • Fax: 225-767-1335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3622
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: