Carol A Maki, RD, CDE

Individual provider Active NPI Registered Dietitian · Hazelhurst, WI

NPI 1962698928 · NPPES record last updated Sep 24, 2007

Key facts

NPI
1962698928
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
1650-029 (WI)
Practice address
5757 Cedar Falls Rd
Hazelhurst, WI 54531-9788
Phone
(715) 358-6591
NPI assigned
Sep 24, 2007
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)
No

State licenses

LicenseStateTypeSpecialty
1650-029WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1650-029 WI Yes

Addresses

Primary practice location

5757 Cedar Falls Rd
Hazelhurst, WI 54531-9788

Mailing address

5757 Cedar Falls Rd
Hazelhurst, WI 54531-9788
Phone (715) 358-6591

Other providers in Hazelhurst, WI

All providers in Hazelhurst, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.