Provider Demographics
NPI:1962098392
Name:COATS, BIANCA PHILLICE (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:BIANCA
Middle Name:PHILLICE
Last Name:COATS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MS
Other - First Name:BIANCA
Other - Middle Name:PHILLICE
Other - Last Name:PLANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:9243 HIGHLAND OAKS AVENUE
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791
Mailing Address - Country:US
Mailing Address - Phone:337-371-1207
Mailing Address - Fax:
Practice Address - Street 1:120 HUNTINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-366-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-20
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3047133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered