MEDICARE: MRS. LAURA C BRUMFIELD 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	133V00000X	Registered Dietitian	1068	LA

General Provider Information

NPI Number	:	1538904305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA C BRUMFIELD RD, LDN

Provider Business Mailing Address
First Line	:	9900 LAKE FOREST BLVD STE F
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2609
Country	:	US
Telephone Number	:	504-620-0500
Fax Number	:	504-620-0522

Provider Business Practice Location Address
First Line	:	9900 LAKE FOREST BLVD STE F
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2609
Country	:	US
Telephone Number	:	504-620-0500
Fax Number	:	504-620-0522

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

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	06/25/2024

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