Provider Demographics
NPI:1932965886
Name:WHITE, LAURA FALKLER (RD, CSG)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:FALKLER
Last Name:WHITE
Suffix:
Gender:F
Credentials:RD, CSG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 WHISPERING PINE LN
Mailing Address - Street 2:
Mailing Address - City:MILLBORO
Mailing Address - State:VA
Mailing Address - Zip Code:24460-2640
Mailing Address - Country:US
Mailing Address - Phone:717-855-3056
Mailing Address - Fax:
Practice Address - Street 1:12303 DE PAUL DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2512
Practice Address - Country:US
Practice Address - Phone:314-344-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Gerontological