Provider Demographics
NPI:1891863775
Name:HARMS, LAURA SUSAN (RD)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:SUSAN
Last Name:HARMS
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:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-286-2080
Mailing Address - Fax:314-286-2085
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM ENDOCRINOLGY, STE 13B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-286-2080
Practice Address - Fax:314-286-2085
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018030740133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT 84062OtherSTATE LICENSE
TX940838OtherCDR