MEDICARE: LAUREN ELIZABETH HESCH RD

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	L004179	NC
2	133V00000X	Registered Dietitian	01064658

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01064658	OTHER		CDR - RD
2	L004179	OTHER	NC	NC LDN

General Provider Information

NPI Number	:	1831855972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELIZABETH HESCH RD

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8707
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-7324
Country	:	US
Telephone Number	:	910-907-7096
Fax Number	:

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

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	05/08/2026

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