Provider Demographics
NPI:1609012228
Name:CHABERT, ELAINA OWENS (MPH, RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:ELAINA
Middle Name:OWENS
Last Name:CHABERT
Suffix:
Gender:F
Credentials:MPH, 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 2668
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-2668
Mailing Address - Country:US
Mailing Address - Phone:985-230-6332
Mailing Address - Fax:985-230-7080
Practice Address - Street 1:15790 PAUL VEGA MD DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1434
Practice Address - Country:US
Practice Address - Phone:985-230-6332
Practice Address - Fax:985-230-7080
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA805652/1630133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered