Individual
MADELINE SHANE GEBHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 FOX DEN TRL, MONROE, LA 71203-6016
(318) 372-0690
Mailing address
407 FOX DEN TRL, MONROE, LA 71203-6016
(318) 372-0690
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86117006
LA
363A00000X
Physician Assistant
Primary
351703
LA
Other
Enumeration date
08/17/2020
Last updated
05/01/2026
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