Individual
JERILYN R ABBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
933 NEWBURY ST, RIPON, WI 54971-1730
(920) 748-9495
Mailing address
933 NEWBURY ST, RIPON, WI 54971-1730
(920) 748-9495
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1004-029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004-029
STATE CERTIFICATION NUMBE
WI
Enumeration date
11/13/2006
Last updated
07/08/2007
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