Provider Demographics
NPI:1932523495
Name:LOUISIANA DEPT HEALTH AND HOSPITALS
Entity Type:Organization
Organization Name:LOUISIANA DEPT HEALTH AND HOSPITALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH NUTRITIONIST 2
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:225-687-9021
Mailing Address - Street 1:24705 PLAZA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-6827
Mailing Address - Country:US
Mailing Address - Phone:225-687-9021
Mailing Address - Fax:
Practice Address - Street 1:24705 PLAZA DR
Practice Address - Street 2:SUITE A
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-6827
Practice Address - Country:US
Practice Address - Phone:225-687-9021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OFFICE OF PUBLIC HEALTH CAPITAL REGION 2
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1023906133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty