Healthcare Provider Details

I. General information

NPI: 1811261035
Provider Name (Legal Business Name): DIANE H YEE RDCD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 INDEX RD
FITCHBURG WI
53713-3117
US

IV. Provider business mailing address

700 S PARK ST
MADISON WI
53715-1830
US

V. Phone/Fax

Practice location:
  • Phone: 608-229-7399
  • Fax: 608-229-7116
Mailing address:
  • Phone: 608-251-6100
  • Fax: 608-229-7116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number730-29
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: