Casey Mitchell, M.S., R.D., C.D.

Individual provider Active NPI Registered Dietitian · Bowler, WI

NPI 1053854885 · NPPES record last updated Nov 28, 2016

Key facts

NPI
1053854885
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
3052-29 (WI)
Practice address
W12802 County Road a
Bowler, WI 54416-9551
Phone
(715) 793-5006
NPI assigned
Nov 28, 2016
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)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3052-29WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3052-29 WI Yes

Addresses

Primary practice location

W12802 County Road a
Bowler, WI 54416-9551

Mailing address

W12802 County Road a
Bowler, WI 54416-9551
Phone (715) 793-5006

Other providers in Bowler, WI

All providers in Bowler, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.