=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447043146
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHANNA K LEGIER MS, RD, LDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2025
-----------------------------------------------------
Last Update Date | 05/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 CUTLASS LN
-----------------------------------------------------
City | FLORIEN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71429-4921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-240-2309
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21 CUTLASS LN
-----------------------------------------------------
City | FLORIEN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71429-4921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-240-2309
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 00967966
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 2229
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------