Provider Demographics
NPI:1629166871
Name:SIGRIST, LORI (PHD, RD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:SIGRIST
Suffix:
Gender:F
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4707
Mailing Address - Country:US
Mailing Address - Phone:508-233-5322
Mailing Address - Fax:508-233-5833
Practice Address - Street 1:WOMACK ARMY MEDICAL CTR
Practice Address - Street 2:BUILDING 4-2817
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06223133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered