Provider Demographics
NPI:1356161889
Name:GAYOWSKI, LAURA MARIE (RDN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:GAYOWSKI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 WADE AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1158
Mailing Address - Country:US
Mailing Address - Phone:919-532-0702
Mailing Address - Fax:
Practice Address - Street 1:9529 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7359
Practice Address - Country:US
Practice Address - Phone:919-678-6302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered