Provider Demographics
NPI:1528678745
Name:VERRY, LAURYNN ELIZABETH (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:LAURYNN
Middle Name:ELIZABETH
Last Name:VERRY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10432 DORSET DR UNIT 17
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2363
Mailing Address - Country:US
Mailing Address - Phone:319-538-6045
Mailing Address - Fax:
Practice Address - Street 1:10432 DORSET DR UNIT 17
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2363
Practice Address - Country:US
Practice Address - Phone:319-538-6045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA099667133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered