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General NPI Number Information
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NPI Number | 1871342006
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Entity Type | Organization
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Legal Business Name | CAKE NUTRITION
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 10125 HIGH PINES DR
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City | BATON ROUGE
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State | LA
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Zip | 70809-5918
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Country | US
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Telephone | 440-532-9712
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Fax |
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Provider Business Mailing Address
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Address Line | 10125 HIGH PINES DR
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City | BATON ROUGE
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State | LA
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Zip | 70809-5918
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Country | US
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Telephone | 440-532-9712
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACOB T MEY
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Credential | PHD, RD
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Telephone | 440-532-9712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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