Provider Demographics
NPI:1093327041
Name:WELDON, ANNE (RD, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:WELDON
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1636
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71052-1636
Mailing Address - Country:US
Mailing Address - Phone:318-871-3101
Mailing Address - Fax:318-872-6134
Practice Address - Street 1:207 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:LA
Practice Address - Zip Code:71052-2603
Practice Address - Country:US
Practice Address - Phone:318-872-4610
Practice Address - Fax:318-872-6134
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA142133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered