Provider Demographics
NPI:1659971406
Name:RUBIO-SERRANO, LAUREN
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:RUBIO-SERRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WINCHESTER PL
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3032
Mailing Address - Country:US
Mailing Address - Phone:828-773-8555
Mailing Address - Fax:
Practice Address - Street 1:16 WINCHESTER PL
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-3032
Practice Address - Country:US
Practice Address - Phone:828-773-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86060053133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered