MEDICARE: LAUREN ASHLEY ZIDEK RDN, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	2549	GA

General Provider Information

NPI Number	:	1164130506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ASHLEY ZIDEK RDN, LD

Provider Business Mailing Address
First Line	:	11 HIDDEN POINTE DRIVE
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31419
Country	:	US
Telephone Number	:	440-935-9052
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 HIDDEN POINTE DRIVE
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31419
Country	:	US
Telephone Number	:	440-935-9052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	05/15/2026

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