Healthcare Provider Details

I. General information

NPI: 1306786595
Provider Name (Legal Business Name): LAURA THOMPSON RD LMNT, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12035 Q ST
OMAHA NE
68137-3542
US

IV. Provider business mailing address

12035 Q ST
OMAHA NE
68137-3542
US

V. Phone/Fax

Practice location:
  • Phone: 402-991-0611
  • Fax: 402-991-6228
Mailing address:
  • Phone: 402-991-0611
  • Fax: 402-991-6228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number2039
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number139235
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2039
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: