Provider Demographics
NPI:1083967731
Name:BROWN, LORI C (RD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 W THOMAS ST
Mailing Address - Street 2:SUITE D-196
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401
Mailing Address - Country:US
Mailing Address - Phone:985-969-2045
Mailing Address - Fax:
Practice Address - Street 1:1905 W THOMAS ST
Practice Address - Street 2:SUITE D-196
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401
Practice Address - Country:US
Practice Address - Phone:985-969-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1874133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered