Healthcare Provider Details

I. General information

NPI: 1629690078
Provider Name (Legal Business Name): LAUREN BINTZ RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6013 FARRINGTON RD
CHAPEL HILL NC
27517-8172
US

IV. Provider business mailing address

18 FEATHERS DR
PLATTSBURGH NY
12901-6461
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-0661
  • Fax:
Mailing address:
  • Phone: 518-324-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: