Provider Demographics
NPI:1639757271
Name:KERN, LAUREN MCCARTHY (MS, RD, LD, IFNCP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MCCARTHY
Last Name:KERN
Suffix:
Gender:F
Credentials:MS, RD, LD, IFNCP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD, IFNCP
Mailing Address - Street 1:6313 LAKE WORTH BLVD # 1029
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-3601
Mailing Address - Country:US
Mailing Address - Phone:682-235-9884
Mailing Address - Fax:
Practice Address - Street 1:1751 RIVER RUN STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6670
Practice Address - Country:US
Practice Address - Phone:682-235-9884
Practice Address - Fax:682-316-9294
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87842133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered