NPI 1063480366

Laura Ann Ivy, LDNRD

Practitioner Registered Dietitian Shreveport, LA

Practice location

Address: 510 E Stoner Ave, Shreveport, LA 71101-4243
Phone: (318) 221-8411
Fax: (318) 429-5724
Mailing address: 4111 Pines Rd, Shreveport, LA 71119-7315

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 884597 (LA)

Other Dietitian, Registered providers in Louisiana →

Registry record

NPI: 1063480366
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Mar 2006
Record last updated: 12 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.