Provider Demographics
NPI:1912249889
Name:CHURCHMAN, SLOANE ELIZABETH (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:SLOANE
Middle Name:ELIZABETH
Last Name:CHURCHMAN
Suffix:
Gender:F
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 1:401 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5864
Mailing Address - Country:US
Mailing Address - Phone:337-478-2650
Mailing Address - Fax:337-478-8183
Practice Address - Street 1:401 DR MICHAEL DEBAKEY DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5864
Practice Address - Country:US
Practice Address - Phone:337-478-2650
Practice Address - Fax:337-478-8183
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2448133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered