Provider Demographics
NPI:1619114089
Name:LAUER, MEGAN LOUISE (RDLDN)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LOUISE
Last Name:LAUER
Suffix:
Gender:F
Credentials:RDLDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 RIDGEWAY RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1023
Mailing Address - Country:US
Mailing Address - Phone:717-652-3881
Mailing Address - Fax:717-541-0317
Practice Address - Street 1:3320 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1023
Practice Address - Country:US
Practice Address - Phone:717-652-3881
Practice Address - Fax:717-541-0317
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002127133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered