Provider Demographics
NPI:1720223522
Name:HANSEN, LAURA ELIZABETH (RD, LDN)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 CENTRE AVE
Mailing Address - Street 2:EAST WING, ROOM EG-02
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1304
Mailing Address - Country:US
Mailing Address - Phone:412-623-1753
Mailing Address - Fax:412-623-2279
Practice Address - Street 1:3601 5TH AVE
Practice Address - Street 2:FALK MEDICAL BUILDING, SUITE B, ROOM 145 B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3403
Practice Address - Country:US
Practice Address - Phone:412-647-0677
Practice Address - Fax:412-647-0453
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004053133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered