Provider Demographics
NPI:1629412119
Name:GREENHOW BRANSFIELD, LAURA (MPH, RD, LDN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GREENHOW BRANSFIELD
Suffix:
Gender:F
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 FAST PARK DR STE 213
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4853
Mailing Address - Country:US
Mailing Address - Phone:919-442-8398
Mailing Address - Fax:888-856-3502
Practice Address - Street 1:8801 FAST PARK DR STE 213
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4853
Practice Address - Country:US
Practice Address - Phone:919-442-8398
Practice Address - Fax:888-856-3502
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004173133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered