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NPI Code Detail

MEDICARE: LAUREN PANOFF MPH, RD, DIPACLM

MEDICARE: LAUREN PANOFF MPH, RD, DIPACLM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1174472542
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN PANOFF MPH, RD, DIPACLM
Provider Business Mailing Address
First Line : PO BOX 1504
Second Line :
City : BROOMFIELD
State : CO
Zip : 80038-1504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3724 JEFFERSON ST STE 104
Second Line :
City : AUSTIN
State : TX
Zip : 78731-6204
Country : US
Telephone Number : 734-560-0628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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