| Doctor Name: | TRACEY ELIZABETH TIMMONS |
| NPI Number: | 1104172261 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, RD, LDN |
| License Number: | 1847 |
| Business Practice Address: | 3236 Kirkman St Lake Charles, LA - 706018640 |
| Business Phone Number: | 3374802632 |
| Business Fax Number: | 3374758613 |
| Mailing Address: | 4650 Nelson Rd Apt 616, LAKE CHARLES |
| State: | LA |
| Postal Code: | 706050801 |
| Phone Number: | 3374790473 |
| Fax Number: | |
| NPI Enumeration Date: | 07/26/2012 |
| NPI Last Update Date: | 07/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1847 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |