Provider Demographics
NPI:1104341551
Name:STUBNA, LAURA (MS, RD, LDN, CNSC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STUBNA
Suffix:
Gender:F
Credentials:MS, RD, LDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY DRIVE C
Mailing Address - Street 2:120 NF-U
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-360-3933
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:120 NF-U
Practice Address - City:PITTBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-360-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004859133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered