Provider Demographics
NPI:1427287895
Name:KEENE, ELOISE DOLORES (MS RD LDN)
Entity type:Individual
Prefix:MS
First Name:ELOISE
Middle Name:DOLORES
Last Name:KEENE
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 1:5522 PERRIER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3133
Mailing Address - Country:US
Mailing Address - Phone:504-210-7254
Mailing Address - Fax:
Practice Address - Street 1:5522 PERRIER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3133
Practice Address - Country:US
Practice Address - Phone:504-210-7254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1611133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered