Provider Demographics
NPI:1124865159
Name:MAGUIRE, LAUREN JENNA (RD, CDCES)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JENNA
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 W FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4039
Mailing Address - Country:US
Mailing Address - Phone:908-247-1408
Mailing Address - Fax:
Practice Address - Street 1:329 W FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4039
Practice Address - Country:US
Practice Address - Phone:908-247-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered