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NPI Code Detail

MEDICARE: CAROLINE LAGRANGE GILMORE RD, LDN

MEDICARE:   CAROLINE LAGRANGE GILMORE  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
1133V00000XRegistered Dietitian1198LA

General Provider Information

NPI Number : 1548657026
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE LAGRANGE GILMORE RD, LDN
Provider Business Mailing Address
First Line : 8490 PICARDY AVE BLDG 600-D
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3731
Country : US
Telephone Number : 225-819-1175
Fax Number :
Provider Business Practice Location Address
First Line : 8490 PICARDY AVE BLDG 600-D
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3731
Country : US
Telephone Number : 225-819-1175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2015
Last Update Date : 11/09/2022

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Directions to “ CAROLINE LAGRANGE GILMORE RD, LDN” Practice Location

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