Provider Demographics
NPI:1649067992
Name:EDWARDS, EMERIE CAROLINE (RDN)
Entity type:Individual
Prefix:
First Name:EMERIE
Middle Name:CAROLINE
Last Name:EDWARDS
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 CLAYTON DR
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:LA
Mailing Address - Zip Code:70079-2453
Mailing Address - Country:US
Mailing Address - Phone:757-240-7899
Mailing Address - Fax:
Practice Address - Street 1:715 CLAYTON DR
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:LA
Practice Address - Zip Code:70079-2453
Practice Address - Country:US
Practice Address - Phone:757-240-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3932133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered