Provider Demographics
NPI:1194273508
Name:DEANA LEONARD
Entity type:Organization
Organization Name:DEANA LEONARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:984-438-0152
Mailing Address - Street 1:173 RUE DE LEVERT
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-2057
Mailing Address - Country:US
Mailing Address - Phone:985-532-6979
Mailing Address - Fax:
Practice Address - Street 1:173 RUE DE LEVERT
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-2057
Practice Address - Country:US
Practice Address - Phone:985-532-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2319282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital