Healthcare Provider Details

I. General information

NPI: 1316360324
Provider Name (Legal Business Name): KIMBERLY K. BAEHMAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY NEHER

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N. RICHMOND ST., STE F NUTRITIONAL HEALING LLC
APPLETON WI
54911
US

IV. Provider business mailing address

400 N. RICHMOND ST., STE F NUTRITIONAL HEALING LLC
APPLETON WI
54911
US

V. Phone/Fax

Practice location:
  • Phone: 920-358-5764
  • Fax:
Mailing address:
  • Phone: 920-358-5764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: