Jennifer Wilfong, RD
Individual provider Active NPI Registered Dietitian · Lorena, TX
NPI 1821606898 · NPPES record last updated Mar 8, 2026
Key facts
- NPI
- 1821606898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DT83244 (TX)
- Practice address
- 400 Gibraltar LN
Lorena, TX 76655-3622 - Phone
- (719) 439-2470
- NPI assigned
- Jul 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240103003720 | TX | Practitioner - Registered Dietitian Or Nutrition Professional | 2961853965 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Etsah Counseling Center, PLLC | Current |
Accepting new patients |
Locations
3500 Hillcrest Dr
Ste 2B
Waco, TX 76708
Phone (254) 230-8501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT83244 | TX | Yes |
Addresses
Primary practice location
400 Gibraltar LN
Lorena, TX 76655-3622
Mailing address
400 Gibraltar LN
Lorena, TX 76655-3622
Phone (719) 439-2470
Other providers in Lorena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.