Christine Swan, R.D.N., C.D.

Individual provider Active NPI Registered Dietitian · Fennimore, WI

NPI 1700204708 · NPPES record last updated Jun 2, 2015

Key facts

NPI
1700204708
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
643584 (WI)
Practice address
14065 Birdseye Rd
Fennimore, WI 53809-9660
Phone
(608) 822-6643
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
643584WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 643584 WI Yes

Addresses

Primary practice location

14065 Birdseye Rd
Fennimore, WI 53809-9660

Mailing address

14065 Birdseye Rd
Fennimore, WI 53809-9660
Phone (608) 822-6643

Other providers in Fennimore, WI

All providers in Fennimore, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.