Laura Lea Anderson, MS, RD, CSSD

Individual provider Active NPI Registered Dietitian · Boulder, CO

NPI 1194900233 · NPPES record last updated Mar 1, 2024

Key facts

NPI
1194900233
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
956752 (CO)
Practice address
585 Pika Rd
Boulder, CO 80302-9518
Phone
(970) 214-8905
NPI assigned
Jan 8, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
956752COMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 956752 CO Yes
Registered Dietitian 133V00000X TX

Addresses

Primary practice location

585 Pika Rd
Boulder, CO 80302-9518

Mailing address

585 Pika Rd
Boulder, CO 80302-9518
Phone (970) 214-8905

Other providers in Boulder, CO

All providers in Boulder, CO · Registered Dietitian in Colorado

Sources for this page

Verify at the official NPI Registry.