Provider Demographics
NPI:1639786908
Name:TINKEY, LAUREN SHAW (MS,RDN,LDN)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:SHAW
Last Name:TINKEY
Suffix:
Gender:F
Credentials:MS,RDN,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 604050
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-4050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 SAM NEWELL RD STE 204
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-7594
Practice Address - Country:US
Practice Address - Phone:980-202-6643
Practice Address - Fax:980-246-9482
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006230133VN1201X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management