Provider Demographics
NPI:1336994441
Name:LANDRY, ADRIAN MARCEL COLE (MS, RD, LDN)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN MARCEL
Middle Name:COLE
Last Name:LANDRY
Suffix:
Gender:M
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 W LEVERT DR
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3102
Mailing Address - Country:US
Mailing Address - Phone:504-346-0191
Mailing Address - Fax:
Practice Address - Street 1:8 W LEVERT DR
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-3102
Practice Address - Country:US
Practice Address - Phone:504-346-0191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3771133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered