Provider Demographics
NPI:1720525603
Name:PORTA, NATALIE (RDN, LDN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:PORTA
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ELIZABETH
Other - Last Name:LAFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:8531 ARABELLA AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-8345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8564 JEFFERSON HWY STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2424
Practice Address - Country:US
Practice Address - Phone:225-636-5410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2553133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered