Provider Demographics
NPI:1700939022
Name:HARRIS, LAURA E (RD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:HARRIS
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 1:809 EDGEMONT NORTH ST NE APT C
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3969
Mailing Address - Country:US
Mailing Address - Phone:276-698-8889
Mailing Address - Fax:
Practice Address - Street 1:809 EDGEMONT NORTH ST NE APT C
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3969
Practice Address - Country:US
Practice Address - Phone:276-698-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered