Healthcare Provider Details

I. General information

NPI: 1932657319
Provider Name (Legal Business Name): LAUREN PAULINE KUTZ MS, RDN, CNSC, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN PAULINE RAZAWICH MS, RDN, CNSC, LDN

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 EMRICK BLVD
BETHLEHEM PA
18020-8012
US

IV. Provider business mailing address

260 VALLEY PARK S
BETHLEHEM PA
18018-1352
US

V. Phone/Fax

Practice location:
  • Phone: 610-258-1585
  • Fax:
Mailing address:
  • Phone: 570-406-9524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN005707
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: