MEDICARE: MS. LAURIE ALLEN MHA,RD,LDN

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
1	133N00000X	Nutritionist	425	LA

General Provider Information

NPI Number	:	1114732708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURIE ALLEN MHA,RD,LDN

Provider Business Mailing Address
First Line	:	1912 BULLARD AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-4918
Country	:	US
Telephone Number	:	985-502-1149
Fax Number	:

Provider Business Practice Location Address
First Line	:	1912 BULLARD AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-4918
Country	:	US
Telephone Number	:	985-502-1149
Fax Number	:	504-584-8268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2025
Last Update Date	:	02/11/2025

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