Rebecca M Altshull, RD

Individual provider Active NPI Registered Dietitian · Watertown, WI

NPI 1023138682 · NPPES record last updated Dec 19, 2008

Key facts

NPI
1023138682
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
1758-029 (WI)
Practice address
125 Hospital Dr
Watertown, WI 53098-3303
Phone
(920) 262-4784
Fax
(920) 262-4640
NPI assigned
Mar 29, 2007
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

State licenses

LicenseStateTypeSpecialty
1758WIMDPsychologist
1758-029WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1758-029 WI Yes

Addresses

Primary practice location

125 Hospital Dr
Watertown, WI 53098-3303

Mailing address

125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 262-4784

Other providers in Watertown, WI

All providers in Watertown, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.