Provider Demographics
NPI:1154751857
Name:SIMON, LAUREN BOURGEOIS (MS, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BOURGEOIS
Last Name:SIMON
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 1:8490 PICARDY AVE
Mailing Address - Street 2:SUITE 1000D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-763-4242
Mailing Address - Fax:225-763-4545
Practice Address - Street 1:8490 PICARDY AVE
Practice Address - Street 2:SUITE 1000D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-763-4242
Practice Address - Fax:225-763-4545
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered