Provider Demographics
NPI:1205618667
Name:BAUER, LAURA MARIE (RDN)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARIE
Last Name:BAUER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 HIGH PLAINS CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6501
Mailing Address - Country:US
Mailing Address - Phone:970-631-4454
Mailing Address - Fax:
Practice Address - Street 1:2715 HIGH PLAINS CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6501
Practice Address - Country:US
Practice Address - Phone:970-631-4454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1021098133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered