Individual
NICHOLLE KAREN SUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2412-29
WI
Other
Enumeration date
11/03/2011
Last updated
07/05/2022
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