Provider Demographics
NPI:1720709710
Name:GRIEF-KING, LAURA G (RDN, LD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:G
Last Name:GRIEF-KING
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CHRISTIN CV
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9553
Mailing Address - Country:US
Mailing Address - Phone:270-559-2597
Mailing Address - Fax:
Practice Address - Street 1:140 CHRISTIN CV
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9553
Practice Address - Country:US
Practice Address - Phone:270-559-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY802666133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered