Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LAURENCE MIKKEL JOHANSEN, MS, RD, CD
Active Sole ProprietorLAURENCE MIKKEL JOHANSEN, MS, RD, CD is a Registered Dietitian healthcare provider located in ELM GROVE, Wisconsin. NPI 1487841979 is currently active in the NPPES registry. Verify at CMS.
Registered Dietitian · ELM GROVE, WI
Registration Details
- NPI Number
- 1487841979
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 27, 2007 (18.838081967768 yrs)
- Last Updated
- Sep 27, 2007
- Licenses
-
2045-29 (WI)963363
- Sole Proprietor
- Yes
Practice Information
- Address
-
12425 KNOLL RDSUITE 110ELM GROVE, WI, 531222657Browse WI providers · Browse ZIP 53122
- Phone
- 2627809788
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- Registered Dietitian
Other Registered Dietitian Providers in ELM GROVE, WI
| Name | Credential | NPI |
|---|---|---|
| SAMANTHA FAYE KUSPA | RDN, CD, LD | 1205349230 |
| ERICA LEIGH GUTIERREZ | RDN | 1285495366 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.