Provider Demographics
NPI:1013320415
Name:HANNIBAL, LAUREN (LD, RD, CDCES)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:HANNIBAL
Suffix:
Gender:F
Credentials:LD, RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1116
Mailing Address - Country:US
Mailing Address - Phone:330-781-7742
Mailing Address - Fax:
Practice Address - Street 1:55 W WATERLOO RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1116
Practice Address - Country:US
Practice Address - Phone:435-651-3700
Practice Address - Fax:435-651-3376
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered