Healthcare Provider Details

I. General information

NPI: 1528546926
Provider Name (Legal Business Name): LAURA YAUTZ RDN, LDN, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10021 SHEFFIELD DR
WEXFORD PA
15090-9659
US

IV. Provider business mailing address

10021 SHEFFIELD DR
WEXFORD PA
15090-9659
US

V. Phone/Fax

Practice location:
  • Phone: 724-991-2099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN003365
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: