Lauren Kaye Samuel, RDN, LD

Individual provider Active NPI Registered Dietitian · Bluffton, OH

NPI 1073154167 · NPPES record last updated Mar 5, 2021

Key facts

NPI
1073154167
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD.08539 (OH)
Practice address
228 N Lawn Ave
Bluffton, OH 45817-1274
Phone
(419) 307-7879
Fax
(419) 520-9314
NPI assigned
Oct 1, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LD.08539OHMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD.08539 OH Yes

Addresses

Primary practice location

228 N Lawn Ave
Bluffton, OH 45817-1274

Mailing address

228 N Lawn Ave
Bluffton, OH 45817-1274
Phone (419) 307-7879

Other practice location 1

1205 E 3rd St
Ottawa, OH 45875-2062
Phone (419) 523-5080

Other providers in Bluffton, OH

All providers in Bluffton, OH · Registered Dietitian in Ohio

Sources for this page

Verify at the official NPI Registry.