Provider Demographics
NPI:1033090600
Name:CARMICHAEL, LAUREN BRITTNEY (RD, LD, CPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:BRITTNEY
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:RD, LD, CPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:BRITTNEY
Other - Last Name:CARMICHAEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD, CPT
Mailing Address - Street 1:120 WINGTIP CV
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 WINGTIP CV
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6068
Practice Address - Country:US
Practice Address - Phone:601-529-0289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD-1647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered