Individual
MRS. JAYNE BEAUREGARD MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN, RD
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 424-6106
(318) 429-5724
Mailing address
1426 W MARIA ST, BOSSIER CITY, LA 71112-3750
(318) 742-9179
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
894
LA
Other
Enumeration date
04/27/2006
Last updated
07/16/2007
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