Provider Demographics
NPI:1124481007
Name:WHITE, LAURA MAEGAN (MA, RD/LDN)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MAEGAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:MA, RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ORCHARD PL
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4621
Mailing Address - Country:US
Mailing Address - Phone:828-835-7562
Mailing Address - Fax:
Practice Address - Street 1:3990 E U.S. HIGHWAY 64 ALTERNATE
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906
Practice Address - Country:US
Practice Address - Phone:828-835-7652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1064101133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered