Healthcare Provider Details

I. General information

NPI: 1235207481
Provider Name (Legal Business Name): JESSICA LYNNE DUNBAR RD LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LYNNE DUNBAR RD

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7665 US HIGHWAY 2
IRON RIVER WI
54847-4690
US

IV. Provider business mailing address

65090 COUNTY HIGHWAY H
IRON RIVER WI
54847-4484
US

V. Phone/Fax

Practice location:
  • Phone: 715-372-5001
  • Fax:
Mailing address:
  • Phone: 612-205-0097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2308
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1714-29
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: