Provider Demographics
NPI:1457108003
Name:CAMPBELL, ASHLYNN VERRETT (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:ASHLYNN
Middle Name:VERRETT
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ASHLAND DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-2937
Mailing Address - Country:US
Mailing Address - Phone:985-226-1440
Mailing Address - Fax:
Practice Address - Street 1:100 ASHLAND DR
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-2937
Practice Address - Country:US
Practice Address - Phone:985-226-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86176221133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered