Carrie Kristen Baum, R.D.

Individual provider Active NPI Registered Dietitian · Appleton, WI

NPI 1154447480 · NPPES record last updated Sep 17, 2015

Key facts

NPI
1154447480
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2049-29 (WI)
Practice address
3925 N Gateway Dr
Appleton, WI 54913-7863
Phone
(920) 749-1171
NPI assigned
Mar 21, 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2049-29 WI Yes

Addresses

Primary practice location

3925 N Gateway Dr
Appleton, WI 54913-7863

Mailing address

3232N Ballard Rd 200
Appleton, WI 54911-8804
Phone (920) 749-9668

Other providers in Appleton, WI

All providers in Appleton, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.