Individual
MRS. JUANITA FELTON BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,L.D.N.,R.D.,CDE
Contact information
Practice address
510 EAST STONER AVENUE, #120, OVERTON BROOKS VA MEDICAL CENTER, SHREVEPORT, LA 71101
(318) 990-5189
(318) 990-5724
Mailing address
510 EAST STONER AVENUE, #120, VETERAN AFFAIRS MEDICAL CENTER, SHREVEPORT, LA 71101
(318) 990-5189
(318) 990-5724
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1095
LICENSE NUMBER
LA
01
—
16541
CDR NUMBER
LA
Enumeration date
03/15/2006
Last updated
02/26/2013
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