| Brooke L Kanigowski, RD, LDN | |
|
420 Avenue F, Bogalusa, LA 70427-3634 | |
| (985) 730-6970 | |
| (985) 730-6363 |
| Full Name | Brooke L Kanigowski |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 420 Avenue F, Bogalusa, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720331895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | DX3242 (Maryland) | Secondary |
| 133V00000X | Dietitian, Registered | 3394 (Louisiana) | Primary |
| Provider Name | Our Lady Of The Lake Physician Group Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
| Provider Name | Our Lady Of The Angels Hospital Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1912334533 PECOS PAC ID: 7012144322 Enrollment ID: O20140602000869 |
| Mailing Address | Practice Location Address |
|---|---|
| Brooke L Kanigowski, RD, LDN 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (985) 730-6970 | Brooke L Kanigowski, RD, LDN 420 Avenue F, Bogalusa, LA 70427-3634 Ph: (985) 730-6970 |
Ms. Lorene A Randazzo, LDN, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 433 Palm St, Bogalusa, LA 70427 Phone: 985-730-6895 Fax: 985-730-6898 | |
Dr. Rebecca Markway Lee, DO, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 420 Avenue F, Bogalusa, LA 70427 Phone: 985-732-0058 | |
Ashley Shuck, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 433 Plaza St, Bogalusa, LA 70427 Phone: 985-730-6970 | |
Rebecca A Hankel, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 400 Memphis St, Bogalusa, LA 70427 Phone: 985-730-6897 Fax: 985-730-6898 | |
Susan D Millet, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10488 Leo Mizell Rd, Bogalusa, LA 70427 Phone: 985-732-6041 | |
Dorothy Dittmer Kenda, RD LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 400 Memphis St, Bogalusa, LA 70427 Phone: 985-730-7177 Fax: 985-730-6898 | |
Mrs. Mary Elizabeth T. Knight, R.D., L.D.N. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 433 Plaza St, Bogalusa, LA 70427 Phone: 985-730-6895 |