Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexa Nicole Wallace, MS, RD, LD

Individual provider Registered Dietitian · NPI 1962146696

Alexa Nicole Wallace, MS, RD, LD is a Registered Dietitian OR Nutrition Professional in Tulsa, Oklahoma. Practices with Warren Clinic Inc, a 772-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2022
What do these letters mean?
MS — Master of Science
A graduate science degree.
RD — Registered Dietitian
A credentialed nutrition professional.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

6160 S Yale Ave
Tulsa, OK 74136-1900
Phone: (918) 497-3140
Fax: (918) 499-3295
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 2528 (OK)

Record details

NPI number1962146696
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , RD , LD
Sole proprietorNo
NPI enumeratedApril 27, 2022
Last updated in NPPESMay 10, 2022
Certification dateMay 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Group practice Warren Clinic Inc — 772 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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