Individual
ANGELINE PETTIT BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LDN, LPN
Contact information
Practice address
2560 COOK RD, RUSTON, LA 71270-3231
(318) 243-7699
Mailing address
2560 COOK RD, RUSTON, LA 71270-3231
(318) 243-7699
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2950
LA
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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