Provider Demographics
NPI:1144877556
Name:MCCLAFFERTY, LINDSEY ALLISON (RD, LD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ALLISON
Last Name:MCCLAFFERTY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 S MEADOWLARK AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-8719
Mailing Address - Country:US
Mailing Address - Phone:417-379-4001
Mailing Address - Fax:
Practice Address - Street 1:3252 S MEADOWLARK AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-8719
Practice Address - Country:US
Practice Address - Phone:417-379-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017024855133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered