Individual
LAURA JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LMNT
Contact information
Practice address
3410 N 156TH ST, OMAHA, NE 68116-2020
(402) 493-0390
Mailing address
3410 N 156TH ST, OMAHA, NE 68116-2020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1140
NE
Other
Enumeration date
05/23/2014
Last updated
12/30/2015
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