Healthcare Provider Details

I. General information

NPI: 1003877341
Provider Name (Legal Business Name): GLORIA M GRON RD,CDE,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 SAXON ST SUITE 200
METAIRIE LA
70006-4187
US

IV. Provider business mailing address

4213 SAXON ST SUITE 200
METAIRIE LA
70006-4187
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-2816
  • Fax: 504-455-5684
Mailing address:
  • Phone: 504-454-2816
  • Fax: 504-455-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number869646
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: