Provider Demographics
NPI:1932657319
Name:KUTZ, LAUREN PAULINE (MS, RDN, CNSC, LDN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:PAULINE
Last Name:KUTZ
Suffix:
Gender:F
Credentials:MS, RDN, CNSC, LDN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:PAULINE
Other - Last Name:RAZAWICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, CNSC, LDN
Mailing Address - Street 1:260 VALLEY PARK S
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1352
Mailing Address - Country:US
Mailing Address - Phone:570-406-9524
Mailing Address - Fax:
Practice Address - Street 1:2710 EMRICK BLVD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8012
Practice Address - Country:US
Practice Address - Phone:610-258-1585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005707133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered