MEDICARE: LAURIN DAYWALT MPH, RD, LDN

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
1	133V00000X	Registered Dietitian	L007057	NC

General Provider Information

NPI Number	:	1306552732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIN DAYWALT MPH, RD, LDN

Provider Business Mailing Address
First Line	:	4705 UNIVERSITY DR BLDG 700
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3489
Country	:	US
Telephone Number	:	919-237-1337
Fax Number	:	919-237-1625

Provider Business Practice Location Address
First Line	:	3904 OLEANDER DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6717
Country	:	US
Telephone Number	:	910-530-1874
Fax Number	:	910-530-1875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	02/04/2026

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