Provider Demographics
NPI:1790299782
Name:BLANCHARD, JESSICA FLORENCE (RD, MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:FLORENCE
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:RD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S CORTEZ ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6119
Mailing Address - Country:US
Mailing Address - Phone:504-309-9618
Mailing Address - Fax:
Practice Address - Street 1:120 S CORTEZ ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6119
Practice Address - Country:US
Practice Address - Phone:504-309-9618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
LA2506133NN1002X, 133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered