Provider Demographics
NPI:1902327893
Name:FITCH, LAURIE A (RD, LD)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:FITCH
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 1:1821 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-1911
Mailing Address - Country:US
Mailing Address - Phone:319-939-1847
Mailing Address - Fax:
Practice Address - Street 1:1821 W 3RD ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-1911
Practice Address - Country:US
Practice Address - Phone:319-939-1847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002116133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered