Kim L Petershack in Madison - Dietitian, Registered
Kim L Petershack - NPI 1346206323
Kim L Petershack is a Dietitian, Registered in Madison, Wisconsin. Kim L Petershack practices all healthcare services and medical treatments related to Dietitian, Registered. The NPI Number for Kim L Petershack is 1346206323. The last update date is 2018-01-23.
Kim L Petershack's current location address is 1313 Fish Hatchery Rd, Madison, Wisconsin. You can contact this provider via phone number 6082528000 and fax number 6082837192. The mailing address for Kim L Petershack is 1313 Fish Hatchery Rd, Madison, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim L Petershack |
|---|---|
| Address | 1313 Fish Hatchery Rd, Madison, Wisconsin |
| Phone Number | 6082528000 |
| Fax Number | 6082837192 |
| Sole Proprietor | N |
| Credentials | CD |
NPI Number Detail
| NPI Number | 1346206323 |
|---|---|
| Provider Enumeration Date | 2006-04-26 |
| Last Updated Date | 2018-01-23 |
Provider Mailing Address Detail
| Address | 1313 Fish Hatchery Rd |
|---|---|
| City | Madison |
| State | Wisconsin (WI) |
| Post Code | 537151911 |
| Phone Number | 6082528000 |
| Fax Number | 6082837192 |
Provider's Primary Taxonomy Detail
| Speciality | Dietitian, Registered |
|---|---|
| Taxonomy | 133V00000X |
| Licence No | 15-029 |
|
Definition: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1948 | WI | DEAN HEALTH INSURANCE |
Post Comment/ Review Below
What is the unique identification code assigned to Kim L Petershack by the Centers for Medicare & Medicaid Services?
The Kim L Petershack has been issued the NPI (National Provider Identifier) 1346206323. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Kim L Petershack located?
The Kim L Petershack is located at 1313 Fish Hatchery Rd, Madison, WI 537151911.
What is Kim L Petershack's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kim L Petershack's specialized field of practice is Dietitian, Registered, and the corresponding taxonomy code that categorizes this area of specialization is 133V00000X.
On what date did the Kim L Petershack receive its 1346206323 assignment from the Centers for Medicare & Medicaid Services?
The Kim L Petershack was assigned its 1346206323 by the Centers for Medicare & Medicaid Services on 2006-04-26.
When was the information regarding Kim L Petershack most recently updated?
The details pertaining to the Kim L Petershack, including its address, specialty, and other relevant information, were last refreshed on 2018-01-23.