Mrs Kira Wilson, RD | |
2817 New Pinery Rd, Portage, WI 53901-9240 | |
(608) 742-4131 | |
Not Available |
Full Name | Mrs Kira Wilson |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 2817 New Pinery Rd, Portage, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396935987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 850777 (Wisconsin) | Primary |
Provider Name | Ut Physicians |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1033157821 PECOS PAC ID: 8426960360 Enrollment ID: O20031107000268 |
Mailing Address | Practice Location Address |
---|---|
Mrs Kira Wilson, RD 882 Mcmillan Rd, Poynette, WI 53955-9227 Ph: (608) 265-0963 | Mrs Kira Wilson, RD 2817 New Pinery Rd, Portage, WI 53901-9240 Ph: (608) 742-4131 |
Gabrielle Lois, RDN, CD. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 600-745-6308 | |
Meredith Ludwig, Dietitian Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-742-4131 | |
Megan M Cornell, MS, RDN, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-742-4131 | |
Emily Kraemer, MS, RDN, CD Dietitian Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-742-4131 |