Provider Demographics
NPI:1003577883
Name:BEGNEL, LAUREN (RD LD)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:BEGNEL
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 FLORINE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5449
Mailing Address - Country:US
Mailing Address - Phone:636-293-3791
Mailing Address - Fax:
Practice Address - Street 1:1310 MENDOTA ST STE 119
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1095
Practice Address - Country:US
Practice Address - Phone:608-747-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22204133V00000X
NMLD-1532133V00000X
MO2015034766133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered