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NPI Code Detail

MEDICARE: MAUREEN ROGERS BREAUX RDN

MEDICARE:   MAUREEN ROGERS BREAUX  RDN
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 Dietitian2752LA

General Provider Information

NPI Number : 1477384808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN ROGERS BREAUX RDN
Provider Business Mailing Address
First Line : 5215 ESSEN LN STE 200
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3543
Country : US
Telephone Number : 225-767-0847
Fax Number : 225-767-1335
Provider Business Practice Location Address
First Line : 1104 W HIGHWAY 30
Second Line :
City : GONZALES
State : LA
Zip : 70737-5003
Country : US
Telephone Number : 225-664-1205
Fax Number : 225-644-5367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2024
Last Update Date : 08/08/2024

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Directions to “ MAUREEN ROGERS BREAUX RDN” Practice Location

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