Janice M Antoniewicz-Werner, CD

Individual provider Active NPI Registered Dietitian · Madison, WI

NPI 1790741288 · NPPES record last updated Aug 9, 2007

Key facts

NPI
1790741288
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
455-029 (WI)
Practice address
1313 Fish Hatchery Rd
Dean Medical Center
Madison, WI 53715-1911
Phone
(608) 252-8000
Fax
(608) 252-8245
NPI assigned
Apr 24, 2006
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

LicenseStateTypeSpecialty
455WIMDCognitive & Behavioral Psychologist
455-029WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 455-029 WI Yes

Addresses

Primary practice location

1313 Fish Hatchery Rd
Dean Medical Center
Madison, WI 53715-1911

Mailing address

1313 Fish Hatchery Rd
Dean Medical Center
Madison, WI 53715-1911
Phone (608) 252-8000

Other identifiers

IdentifierTypeStateIssuer
715OtherWIDEAN HEALTH INSURANCE

Other providers in Madison, WI

All providers in Madison, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.