Nicole Kerneen, R.D.,C.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1461-029 Issued in WI

Practice address

1149 Elm Lawn St
Wauwatosa, WI 53213

Phone

(414) 940-6662

NPI assigned

Mar 21, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1285875211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 ELM LAWN ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532133031",
            "telephone_number": "414-940-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 ELM LAWN ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53213",
            "telephone_number": "414-940-6662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7635 W Bluemound Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532133500",
            "country_code": "US",
            "telephone_number": "414-940-6662",
            "fax_number": "414-774-6662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8700 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532263595",
            "country_code": "US",
            "telephone_number": "414-805-8656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERNEEN",
        "first_name": "NICOLE",
        "credential": "R.D.,C.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-21",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1461-029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne M Kelley, RN
• Derk Kelly, PT,DPT
• Thomas Kelly, M.D.
• Julia Elizabeth Kennedy, D.D.S
• Steven Thomas Kennedy, DC
• Kelly Kershaw, R.N.
• Ellen Marie Ketter, PA-C
• James Patrick Ketterhagen, M.D.
• Karen Keyzer
• Naba Khan

• Registered Dietitian in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.