Provider Demographics
NPI:1154921997
Name:PRIGGE, LAUREN ANNELISE (MS, RD, LDN, NBC-HWC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANNELISE
Last Name:PRIGGE
Suffix:
Gender:F
Credentials:MS, RD, LDN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TRIDENT CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8692
Mailing Address - Country:US
Mailing Address - Phone:919-749-5929
Mailing Address - Fax:
Practice Address - Street 1:8364 SIX FORKS RD STE 104
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5085
Practice Address - Country:US
Practice Address - Phone:919-990-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004677133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered