Provider Demographics
NPI:1770224842
Name:ROBERTS, MADELINE LAUREN (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:LAUREN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:MRS
Other - First Name:MADELINE
Other - Middle Name:LAUREN
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:2002 WAYNEDALE CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-7972
Mailing Address - Country:US
Mailing Address - Phone:513-484-8591
Mailing Address - Fax:
Practice Address - Street 1:2002 WAYNEDALE CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-7972
Practice Address - Country:US
Practice Address - Phone:513-484-8591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered