Bonnie J Hessedal, RD | |
110 E 5th Ave, Antigo, WI 54409-2710 | |
(715) 623-2351 | |
(715) 627-6183 |
Full Name | Bonnie J Hessedal |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 110 E 5th Ave, Antigo, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023233822 | NPI | - | NPPES |
1023233822 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 1343-029 (Wisconsin) | Primary |
Provider Name | Aspirus Medical Group Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1669595294 PECOS PAC ID: 1052223625 Enrollment ID: O20031103000267 |
Provider Name | Langlade Hospital - Hotel Dieu Of St Joseph Of Antigo Wisconsin |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1831251040 PECOS PAC ID: 1557271202 Enrollment ID: O20040212000310 |
Mailing Address | Practice Location Address |
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Bonnie J Hessedal, RD Po Box 1405, Wausau, WI 54402-1405 Ph: (715) 847-2304 | Bonnie J Hessedal, RD 110 E 5th Ave, Antigo, WI 54409-2710 Ph: (715) 623-2351 |
Kathleen M Bender, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 110 E 5th Ave, Antigo, WI 54409 Phone: 715-623-2351 | |
Kathleen Sislo, RDN, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 112 E 5th Ave, Antigo, WI 54409 Phone: 715-623-2331 | |
Genda Sue Freeman, RD, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 112 E 5th Ave, Antigo, WI 54409 Phone: 715-623-9873 |