# FUNCTIONAL NUTRITION & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Functional Nutrition & Wellnes
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932082344
- **Authorized official:** CHERYL ANN PAUL PA (OWNER)
- **Authorized official phone:** (920) 286-2800

## Contact information

- **Practice address:** 1200 MAIN ST, SAINT CLOUD, WI 53079-1476
- **Practice address phone:** (920) 286-2800
- **Mailing address:** N2999 HONEYMOON HILL RD, NEW HOLSTEIN, WI 53061-9727
- **Mailing address phone:** (920) 286-2800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/31/2025
- **Last updated:** 07/31/2025