Shannon M McCarthy, RD

Individual provider Active NPI Registered Dietitian · Whitefish Bay, WI

NPI 1124891965 · NPPES record last updated Nov 8, 2023

Key facts

NPI
1124891965
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2635-29 (WI)
Practice address
5018 N Hollywood Ave
Whitefish Bay, WI 53217-5601
Phone
(414) 699-3085
NPI assigned
Nov 2, 2023
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

State licenses

LicenseStateTypeSpecialty
2635-29WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2635-29 WI Yes

Addresses

Primary practice location

5018 N Hollywood Ave
Whitefish Bay, WI 53217-5601

Mailing address

5018 N Hollywood Ave
Whitefish Bay, WI 53217-5601
Phone (414) 699-3085

Other providers in Whitefish Bay, WI

All providers in Whitefish Bay, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.