Provider Demographics
NPI:1295133445
Name:FAUCHEUX, LAURA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FAUCHEUX
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 1:1097 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-3407
Mailing Address - Country:US
Mailing Address - Phone:337-355-1269
Mailing Address - Fax:337-828-6378
Practice Address - Street 1:1097 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-3407
Practice Address - Country:US
Practice Address - Phone:337-355-1269
Practice Address - Fax:337-828-6378
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA956133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered