Provider Demographics
NPI:1750894804
Name:SCHMUTZER, LAURA LANI (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LANI
Last Name:SCHMUTZER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LANI
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2304 HENPECK LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5209
Mailing Address - Country:US
Mailing Address - Phone:501-366-1947
Mailing Address - Fax:
Practice Address - Street 1:2304 HENPECK LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5209
Practice Address - Country:US
Practice Address - Phone:501-366-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3107133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered