Provider Demographics
NPI:1164169397
Name:HAWLEY, LAUREN NICHOLE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICHOLE
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 LAKE BOONE TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6685
Mailing Address - Country:US
Mailing Address - Phone:919-784-2741
Mailing Address - Fax:919-784-2801
Practice Address - Street 1:4207 LAKE BOONE TRL STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6685
Practice Address - Country:US
Practice Address - Phone:919-784-2741
Practice Address - Fax:919-784-2801
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006867133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered