Individual
WENDY BROEKEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
4602 EASTPARK BLVD, MADISON, WI 53718-2002
(608) 263-1530
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3313
WI
133V00000X
Registered Dietitian
—
—
174H00000X
Health Educator
146635
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002101
COMMISSION ON DIETETIC REGISTRATION
—
01
—
3313
CERTIFIED DIETITIAN
WI
Enumeration date
07/07/2015
Last updated
12/16/2020
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