Provider Demographics
NPI:1962750802
Name:NELSON, TERRI KELLER (MS, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:KELLER
Last Name:NELSON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:KELLER
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4326
Mailing Address - Country:US
Mailing Address - Phone:225-246-9790
Mailing Address - Fax:225-246-9100
Practice Address - Street 1:7373 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4326
Practice Address - Country:US
Practice Address - Phone:225-246-9790
Practice Address - Fax:225-246-9100
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA867915133N00000X
LA1273133N00000X, 133V00000X
867915133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist