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NPI Code Detail

MEDICARE: MS. PAMELA JEAN BASSETT R.D.

MEDICARE: MS. PAMELA JEAN BASSETT R.D.
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 Dietitian494LA
2133V00000XRegistered Dietitian2011TN
3133V00000XRegistered DietitianD1015MS

General Provider Information

NPI Number : 1194023127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAMELA JEAN BASSETT R.D.
Provider Business Mailing Address
First Line : 1907 STONEGATE CT
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-5467
Country : US
Telephone Number : 225-802-8062
Fax Number : 225-275-4789
Provider Business Practice Location Address
First Line : 5266 COMMERCE ST
Second Line :
City : SAINT FRANCISVILLE
State : LA
Zip : 70775-4409
Country : US
Telephone Number : 225-635-3811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2011
Last Update Date : 02/28/2011

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