Provider Demographics
NPI:1639378755
Name:LAFFERT, VANESSA K (RD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:K
Last Name:LAFFERT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 LAKE AVE N
Mailing Address - Street 2:UMASS MEMORIAL MEDICAL CENTER NUTRITION DEPT
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01655-0002
Mailing Address - Country:US
Mailing Address - Phone:508-334-4572
Mailing Address - Fax:508-856-8020
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:UMASS MEMORIAL MEDICAL CENTER NUTRITION DEPT
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:508-334-4572
Practice Address - Fax:508-856-8020
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1148133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric