Lauren Nicole Walck, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN007799 Issued in PA

Practice address

1000 East Mountain Blvd
Wilkes Barre, PA 18711-0027

Phone

(570) 808-7803

Fax

(570) 808-3230

NPI assigned

Jan 25, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1619739612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-7803",
            "fax_number": "570-808-3230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185102369",
            "country_code": "US",
            "telephone_number": "570-703-8272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALCK",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN007799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Wagner
• Alisha R Wainwright, PA-C
• Abigail Grace Waite
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Thomas Matthew Walent III, O.D.
• Walgreen Co.
• Donna Walk, CRNP
• Christine Ann Wall, R.N.
• Patrick Wall, APC

• Registered Dietitian in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.