Kimberly Damrow, RD
Individual provider Active NPI Registered Dietitian · Oneida, WI
NPI 1417488289 · NPPES record last updated Mar 23, 2017
Key facts
- NPI
- 1417488289
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1073029 (WI)
- Practice address
- 525 Airport Drive
Oneida, WI 54155-0935 - Phone
- (920) 869-2711
- NPI assigned
- Mar 23, 2017
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1073029 | WI | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1073029 | WI | Yes |
Addresses
Primary practice location
525 Airport Drive
Oneida, WI 54155-0935
Mailing address
PO Box 365
Oneida, WI 54155-0365
Phone (920) 869-2711
Other names
- Kimberly Jo Wavrunek
Other providers in Oneida, WI
- Maria L Boeck
- Charles Montgomery Castleberg
- Lauren Marie Cornette
- Sean Cropper
- Denise Ann Curtin
- David M Danby
- Constance Danforth
- Jane Mary Daul
- Hannah Lynn Desroberts
- Sarah Dykstra
All providers in Oneida, 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 23, 2017. 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.