Organization
INGRAM'S NUTRITION CONSULTATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIETTE SHIVERS NP (CEO/COMMUNITY NUTRITION)
(318) 572-6157
Entity
Organization
Contact information
Practice address
219 E GREGG ST, SHREVEPORT, LA 71104-5158
(318) 572-6157
(800) 708-7349
Mailing address
219 E GREGG ST, SHREVEPORT, LA 71104-5158
(318) 572-6157
(800) 708-7349
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
07/15/2021
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