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

Susan Elizabeth Wallace, RD, LD

Individual provider Registered Dietitian · NPI 1376842732

Susan Elizabeth Wallace, RD, LD is a Registered Dietitian in Lakeside Park, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2011
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.
LD — Licensed Dietitian
A dietitian licensed by a state board.

See every abbreviation used in this directory →

Practice location Address checks out

102 Carran Dr
Lakeside Park, KY 41017-2233
Phone: (859) 331-2939
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence KY-1998 (KY)

Record details

NPI number1376842732
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD , LD
Sole proprietorYes
NPI enumeratedMarch 23, 2011
Last updated in NPPESMarch 23, 2011