Jackie L Havel, RD
Individual provider Active NPI Registered Dietitian · Oneida, WI
NPI 1003323692 · NPPES record last updated Jan 4, 2018
Key facts
- NPI
- 1003323692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2615-29 (WI)
- Practice address
- 525 Airport Dr
Oneida, WI 54155-9035 - Phone
- (920) 869-2711
- Fax
- (920) 869-1782
- NPI assigned
- Jan 4, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2615-29 | WI | Yes |
Addresses
Primary practice location
525 Airport Dr
Oneida, WI 54155-9035
Mailing address
PO Box 365
Oneida, WI 54155-0365
Phone (920) 869-2711
Other providers in Oneida, WI
- Kristina L Erickson
- Michael Flood
- Lisa Frechette
- Marie-Andree Claudette Gelinas
- Jason Gospodarek
- Healthy Living Chiropractic Clinic Inc.
- Susan Higgs
- Betsy Hoida
- Divya Hotchandani
- Alyssa J Hudak
All providers in Oneida, WI · Registered Dietitian in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.