Individual provider · NPI-1

Laura Michelle Andersen, RDN

Dietitian, Registered · Broomfield, CO

NPI number1508368531
StatusActive
Last updated in NPPESMar 6, 2018

Details

NPI
1508368531
Entity type
Individual (NPI-1)
Name
Laura Michelle Andersen
Credential
RDN
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 6, 2018
Last updated
Mar 6, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered86079561–Yes

Practice location

9749 Teller Ln
Broomfield, CO 80021-4086

Phone 720-495-9149

Mailing address

169 Post Oak Ln
Sanford, NC 27330-9600

Phone 720-495-9149

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