Individual
MRS. KIMBERLY LYLES CORMIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
4630 AMBASSADOR CAFFERY PKWY STE 408, LAFAYETTE, LA 70508-6950
(337) 470-3980
(337) 470-3989
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0002
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2220
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2220
STATE LICENSE
LA
Enumeration date
01/26/2018
Last updated
08/25/2021
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