Healthcare Provider Details

I. General information

NPI: 1740503234
Provider Name (Legal Business Name): LAUREN C SINEATH R.D. L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5257 STOCKTON PASS
TRUSSVILLE AL
35173
US

IV. Provider business mailing address

5257 STOCKTON PASS
TRUSSVILLE AL
35173
US

V. Phone/Fax

Practice location:
  • Phone: 205-602-3714
  • Fax:
Mailing address:
  • Phone: 205-602-3714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number2341
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2341
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2341
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: