Individual
KELLY S LUTZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
345 W WASHINGTON AVE, MADISON, WI 53703-2996
(608) 417-8300
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2247-029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2247-029
CERTIFIED DIETITIAN
WI
Enumeration date
03/12/2015
Last updated
04/26/2017
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