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NPI Code Detail

MEDICARE: MRS. KIZZY TURNER BROADEN LDN,RD

MEDICARE: MRS. KIZZY TURNER BROADEN LDN,RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian1723LA

General Provider Information

NPI Number : 1033384425
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIZZY TURNER BROADEN LDN,RD
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-330-0497
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 6400 PERKINS RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4124
Country : US
Telephone Number : 225-330-0497
Fax Number : 225-330-0498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2008
Last Update Date : 10/25/2023

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