Provider Demographics
NPI:1023717584
Name:BISSETT, LAURIE G (RD)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:G
Last Name:BISSETT
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 1:2595 VIEJO CT
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436
Mailing Address - Country:US
Mailing Address - Phone:603-809-3345
Mailing Address - Fax:
Practice Address - Street 1:565 RIO VISTA DRIVE
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406
Practice Address - Country:US
Practice Address - Phone:775-423-3634
Practice Address - Fax:775-423-2287
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered