MEDICARE: DIABETES & NUTRITION EDUCATORS, LLC

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	1008	LA

General Provider Information

NPI Number	:	1922285154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIABETES & NUTRITION EDUCATORS, LLC

Provider Business Mailing Address
First Line	:	15455 MANCHESTER RD UNIT 13
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63022-5002
Country	:	US
Telephone Number	:	337-207-9343
Fax Number	:	866-438-4042

Provider Business Practice Location Address
First Line	:	100 LYNN DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-4512
Country	:	US
Telephone Number	:	337-654-5971
Fax Number	:	337-330-2581

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MELISSA LYNN ARMATTA
Credential	:	LDN,RD,CDE
Telephone Number	:	337-207-9343

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	01/05/2018

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