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NPI Code Detail

MEDICARE: ERIN NICOLE WAYLAND MS, RDN, LD

MEDICARE:   ERIN NICOLE WAYLAND  MS, 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1588549687
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN NICOLE WAYLAND MS, RDN, LD
Provider Business Mailing Address
First Line : 2109 AMIYAH FALLS RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-3523
Country : US
Telephone Number : 817-228-9409
Fax Number :
Provider Business Practice Location Address
First Line : 2109 AMIYAH FALLS RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-3523
Country : US
Telephone Number : 817-228-9409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2025
Last Update Date : 08/07/2025

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Directions to “ ERIN NICOLE WAYLAND MS, RDN, LD” Practice Location

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