Provider Demographics
NPI:1952681249
Name:THOMPSON, ALEXIS WEILBAECHER (RD, LDN, CLT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:WEILBAECHER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RD, LDN, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 ELMWOOD PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2308
Mailing Address - Country:US
Mailing Address - Phone:504-736-4610
Mailing Address - Fax:
Practice Address - Street 1:1200 S CLEARVIEW PKWY
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-2300
Practice Address - Country:US
Practice Address - Phone:504-733-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2308133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3C6697061Medicare PIN