| Roxanne Campbell, RD, LDN | |
|
1024 South East Ascension Complex Blvd, Gonzales, LA 70737-4263 | |
| (225) 765-5500 | |
| (225) 644-2822 |
| Full Name | Roxanne Campbell |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 1024 South East Ascension Complex Blvd, Gonzales, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053666909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1432 (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 |
| Mailing Address | Practice Location Address |
|---|---|
| Roxanne Campbell, RD, LDN 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 765-5500 | Roxanne Campbell, RD, LDN 1024 South East Ascension Complex Blvd, Gonzales, LA 70737-4263 Ph: (225) 765-5500 |
Maureen Rogers Breaux, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 1104 W Highway 30, Gonzales, LA 70737 Phone: 225-664-1205 Fax: 225-644-5367 | |
Jessica F Coffee, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 2647 S Saint Elizabeth Blvd Ste 221, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-644-2023 | |
Kelsee Michelle Moran, RDN, LDN Dietitian Medicare: Medicare Enrolled Practice Location: 1024 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-644-2822 | |
Tamisha Molden, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 609 Saint Francis Pkwy Apt 4204, Gonzales, LA 70737 Phone: 225-341-0509 | |
Cheri S Landry, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737 Phone: 225-647-8511 Fax: 225-644-5213 |