Healthcare Provider Details

I. General information

NPI: 1598136301
Provider Name (Legal Business Name): AMANDA E. MEYER RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 PAUL MAILLARD RD
LULING LA
70070-4349
US

IV. Provider business mailing address

3912 DAVID DR
METAIRIE LA
70003-3419
US

V. Phone/Fax

Practice location:
  • Phone: 985-785-6242
  • Fax:
Mailing address:
  • Phone: 504-952-9965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2663
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: