Provider Demographics
NPI:1861791279
Name:LAUDANO, MERCEDES MONTES (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:MONTES
Last Name:LAUDANO
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 BRITTANY PARC DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2954
Mailing Address - Country:US
Mailing Address - Phone:703-395-3599
Mailing Address - Fax:
Practice Address - Street 1:2337 BRITTANY PARC DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2954
Practice Address - Country:US
Practice Address - Phone:703-395-3599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3182133N00000X
DCDI100000551133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist