Basic Information
| Provider Information | |||||||||
| NPI: | 1922774918 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORGERON | ||||||||
| FirstName: | VIVIANE | ||||||||
| MiddleName: | M C | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | RDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 CITY PLACE DR APT A | ||||||||
| Address2: | |||||||||
| City: | LOCKPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703745119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9852781285 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8585 PICARDY AVE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708093748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257634000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2021 | ||||||||
| LastUpdateDate: | 08/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 3266 | LA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.