MEDICARE: KERRI DOTSON RDN, 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	133V00000X	Registered Dietitian	2574	LA

General Provider Information

NPI Number	:	1194105643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI DOTSON RDN, LDN

Provider Business Mailing Address
First Line	:	300 N BROAD ST
Second Line	:	SUITE 102
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-5577
Country	:	US
Telephone Number	:	504-988-9108
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N BROAD ST
Second Line	:	SUITE 102
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-5577
Country	:	US
Telephone Number	:	504-988-9108
Fax Number	:

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

Provider Enumeration Date	:	05/30/2015
Last Update Date	:	05/30/2015

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