Doctor Name: | MRS. LORIE ANN BOURNE |
NPI Number: | 1114390390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., R.D., L.D., |
License Number: | 2005002998 |
Business Practice Address: | 1000 W 10th St Rolla, MO - 654012905 |
Business Phone Number: | 5734588337 |
Business Fax Number: | |
Mailing Address: | 607 E 5th St, ROLLA |
State: | MO |
Postal Code: | 654013416 |
Phone Number: | 5736478727 |
Fax Number: | |
NPI Enumeration Date: | 11/10/2015 |
NPI Last Update Date: | 11/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 2005002998 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |