Provider Demographics
NPI:1306363122
Name:ZUST, LAUREN E (RD, LD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:ZUST
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 1:2900 DEVILS GLEN RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3381
Mailing Address - Country:US
Mailing Address - Phone:563-332-8496
Mailing Address - Fax:563-332-0804
Practice Address - Street 1:2900 DEVILS GLEN RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3381
Practice Address - Country:US
Practice Address - Phone:563-332-8496
Practice Address - Fax:563-332-0804
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086869133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered