Jenna S. Berg, RD CE
Individual provider Active NPI Registered Dietitian · Wausau, WI
NPI 1578868071 · NPPES record last updated Jan 14, 2011
Key facts
- NPI
- 1578868071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2246 (WI)
- Practice address
- 2727 Plaza Dr
Wausau, WI 54401-4129 - Phone
- (715) 847-3000
- NPI assigned
- Jan 14, 2011
- 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 |
|---|---|---|---|
| 2246 | WI | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2246 | WI | Yes |
Addresses
Primary practice location
2727 Plaza Dr
Wausau, WI 54401-4129
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
Other providers in Wausau, WI
- Heather Bennett
- Lucille Michelle Benson
- Steven A. Benson
- Ronda J Benz
- Lara J Beranek
- Mollie J Berg
- Barbara Berghammer
- Krystal R Berlin
- Boris Berman
- Laura Berry
All providers in Wausau, 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 Jan 14, 2011. 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.