Provider Demographics
NPI:1255712410
Name:VESTA BATCHELDER LDN RD INC
Entity type:Organization
Organization Name:VESTA BATCHELDER LDN RD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:VESTA
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:BATCHELDER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:985-264-8334
Mailing Address - Street 1:214 MACK LN
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9547
Mailing Address - Country:US
Mailing Address - Phone:985-264-8334
Mailing Address - Fax:985-206-5141
Practice Address - Street 1:214 MACK LN
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-9547
Practice Address - Country:US
Practice Address - Phone:985-264-8334
Practice Address - Fax:985-206-5141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA281133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty