Individual
DIANE K WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CDE
Contact information
Practice address
3144 VANZILE ROAD, CRANDON, WI 54520-0275
(715) 478-5180
(715) 478-5904
Mailing address
1 N HILL ROAD, WAUSAU, WI 54403
(715) 478-5180
(715) 478-5904
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
90435 30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90435 30
WI LICENSE
WI
Enumeration date
01/24/2011
Last updated
01/24/2011
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