Kristine Benusa, R.D.

Individual provider Active NPI Registered Dietitian · Whitehall, WI

NPI 1487973681 · NPPES record last updated Jun 16, 2018

Key facts

NPI
1487973681
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
809073 (WI)
Practice address
18601 Lincoln St
Whitehall, WI 54773-8605
Phone
(715) 538-4361
NPI assigned
May 27, 2010
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
809073WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Registered Dietitian 133V00000X 809073 WI Yes

Addresses

Primary practice location

18601 Lincoln St
Whitehall, WI 54773-8605

Mailing address

18601 Lincoln St
Whitehall, WI 54773-8605
Phone (715) 538-4361

Other identifiers

IdentifierTypeStateIssuer
0001OtherWIWPS/MEDICARE PART B
P47127OtherWIUPIN

Other providers in Whitehall, WI

All providers in Whitehall, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.