Doctor Name: | LAURA A HEGENAUER |
NPI Number: | 1063475515 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | |
Business Practice Address: | 300 E Warwick Dr Alma, MI - 488011014 |
Business Phone Number: | 9894663330 |
Business Fax Number: | 9894632540 |
Mailing Address: | Po Box 608, ALMA |
State: | MI |
Postal Code: | 488010608 |
Phone Number: | 9894663330 |
Fax Number: | 9894632540 |
NPI Enumeration Date: | 04/07/2006 |
NPI Last Update Date: | 07/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133VN1005X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | Nutrition, Renal |
Taxonomy Definition: |