Diane L Johnson, RD
Dietitian, Registered in Minocqua, WI. Individual provider (NPI-1).
NPI number1790880433
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1790880433
- Entity type
- Individual (NPI-1)
- Name
- Diane L Johnson
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 14, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1512 | WI | Yes |
Practice location
9601 Townline RdMinocqua, WI 54548
Phone 715-358-1000
Mailing address
1000 N Oak AveMarshfield, WI 54449-5777
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