Healthcare Provider Details

I. General information

NPI: 1922736230
Provider Name (Legal Business Name): LAURA DOWNER RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 30TH ST STE 201
BOULDER CO
80301-1238
US

IV. Provider business mailing address

2500 30TH ST STE 201
BOULDER CO
80301-1238
US

V. Phone/Fax

Practice location:
  • Phone: 615-212-9330
  • Fax:
Mailing address:
  • Phone: 615-212-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3860
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.023847
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT91022
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: