Healthcare Provider Details

I. General information

NPI: 1922285154
Provider Name (Legal Business Name): DIABETES & NUTRITION EDUCATORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LYNN DR
LAFAYETTE LA
70508-4512
US

IV. Provider business mailing address

15455 MANCHESTER RD UNIT 13
BALLWIN MO
63022-5002
US

V. Phone/Fax

Practice location:
  • Phone: 337-654-5971
  • Fax: 337-330-2581
Mailing address:
  • Phone: 337-207-9343
  • Fax: 866-438-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1008
License Number StateLA

VIII. Authorized Official

Name: MS. MELISSA LYNN ARMATTA
Title or Position: OWNER
Credential: LDN,RD,CDE
Phone: 337-207-9343