Provider Demographics
NPI:1922736230
Name:DOWNER, LAURA (RDN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DOWNER
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 1:6339 CHARLOTTE PIKE # 669
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-2926
Mailing Address - Country:US
Mailing Address - Phone:501-804-7313
Mailing Address - Fax:
Practice Address - Street 1:6339 CHARLOTTE PIKE # 669
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2926
Practice Address - Country:US
Practice Address - Phone:501-804-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-13
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT91022133V00000X
TN3860133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered