Individual
MISS EMMA MARIE GELLERSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
621 SCIENCE DR, MADISON, WI 53711-1074
(608) 265-8303
Mailing address
321 WISCONSIN AVE APT 4, MADISON, WI 53703-4110
(309) 781-7154
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5028-29
WI
171400000X
Health & Wellness Coach
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5028-29
STATE OF WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
01
—
86253882
COMMISSION ON DIETETIC REGISTRATION
IA
Enumeration date
09/29/2022
Last updated
03/01/2024
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