Jennifer Lynn Wyrick
Individual provider Active NPI Registered Dietitian · Deforest, WI
NPI 1093653305 · NPPES record last updated Mar 25, 2026
Key facts
- NPI
- 1093653305
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 507 Valley Dr
Deforest, WI 53532-3067 - Phone
- (608) 279-5289
- NPI assigned
- Mar 25, 2026
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | WI | Yes |
Addresses
Primary practice location
507 Valley Dr
Deforest, WI 53532-3067
Mailing address
507 Valley Dr
Deforest, WI 53532-3067
Phone (608) 279-5289
Other providers in Deforest, WI
- Jennifer A Victor
- Paul Villarreal
- Amanda Wagner
- Dolores Wasylik
- Morgan Wochinski
- Shannon Elizabeth Young
All providers in Deforest, 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 Mar 25, 2026. 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.