Individual
CHELSEA RAE BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD, MS
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 867-4122
Mailing address
606 BEYER DR, BAY SAINT LOUIS, MS 39520-2802
(813) 784-5754
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1708
MS
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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