Individual
NICOLE KERNEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.,C.D.
Contact information
Practice address
1149 ELM LAWN ST, WAUWATOSA, WI 53213
(414) 940-6662
Mailing address
1149 ELM LAWN ST, WAUWATOSA, WI 53213-3031
(414) 940-6662
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1461-029
WI
Other
Enumeration date
03/21/2009
Last updated
07/25/2018
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