Provider Demographics
NPI:1699473082
Name:HYDE, ALLISON MARIE (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:HYDE
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:HYDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:54 CORONADO AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3018
Practice Address - Country:US
Practice Address - Phone:504-962-6262
Practice Address - Fax:504-702-3250
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2979133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered