Rachael Omdoll
Individual provider Active NPI Registered Dietitian · Palmyra, WI
NPI 1255946166 · NPPES record last updated Sep 9, 2020
Key facts
- NPI
- 1255946166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86085606 (WI)
- Practice address
- 700 Airview Dr
Palmyra, WI 53156-9204 - Phone
- (262) 378-9270
- NPI assigned
- Sep 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86085606 | WI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86085606 | WI | Yes |
Addresses
Primary practice location
700 Airview Dr
Palmyra, WI 53156-9204
Mailing address
700 Airview Dr
Palmyra, WI 53156-9204
Phone (262) 378-9270
Other providers in Palmyra, WI
- Kettle Moraine Behavioral Health
- Randall R Leanna
- Connie Elisabeth Meyer
- Sarah A Moore
- Kimberly Lynn Nations
- Palmyra Fire District
- Palmyra-Eagle Area School District
- Elizabeth Susan Reid
- Colleen A Ryan
- Shannon Seegers
All providers in Palmyra, 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 Sep 9, 2020. 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.