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NPI Code Detail

MEDICARE: MARGARET DIANE HORRIGAN RD

MEDICARE: MARGARET DIANE HORRIGAN RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian86104695WI
2133V00000XRegistered Dietitian6202WI

General Provider Information

NPI Number : 1093417214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET DIANE HORRIGAN RD
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3365 S 103RD ST STE 100
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-4162
Country : US
Telephone Number : 414-321-3951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2023
Last Update Date : 02/18/2026

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Directions to “ MARGARET DIANE HORRIGAN RD” Practice Location

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