Individual
JESSE J BONVILLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1928
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1928
REGISTERED DIETITIAN
LA
Enumeration date
05/14/2007
Last updated
11/05/2008
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