Provider Demographics
NPI:1699056275
Name:ELIAN, LAURIE ANNE (RD)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANNE
Last Name:ELIAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1266
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-1266
Mailing Address - Country:US
Mailing Address - Phone:828-448-3601
Mailing Address - Fax:828-439-4421
Practice Address - Street 1:700 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-6762
Practice Address - Country:US
Practice Address - Phone:828-448-3601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC708751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered