Provider Demographics
NPI:1942441761
Name:PERKINS, KAREN P (RD,LDN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:P
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 FRENCHMANS BEND RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-8797
Mailing Address - Country:US
Mailing Address - Phone:318-348-7974
Mailing Address - Fax:318-362-4241
Practice Address - Street 1:2408 BROADMOOR BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2963
Practice Address - Country:US
Practice Address - Phone:318-348-7974
Practice Address - Fax:318-362-4241
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA573133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered