Provider Demographics
NPI:1245466069
Name:PUMA, AMBER POOLE (RDN, LDN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:POOLE
Last Name:PUMA
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13386 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-6572
Mailing Address - Country:US
Mailing Address - Phone:985-351-4484
Mailing Address - Fax:
Practice Address - Street 1:13386 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6572
Practice Address - Country:US
Practice Address - Phone:985-351-4484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1671133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered