Provider Demographics
NPI:1083228951
Name:PORCHE, JULIA PALMISANO (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:PALMISANO
Last Name:PORCHE
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 EXETER RUN
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-8060
Mailing Address - Country:US
Mailing Address - Phone:504-615-0377
Mailing Address - Fax:
Practice Address - Street 1:218 EXETER RUN
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-8060
Practice Address - Country:US
Practice Address - Phone:504-615-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2762133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered