Healthcare Provider Details

I. General information

NPI: 1396528253
Provider Name (Legal Business Name): TAYLOR R ERHOLTZ RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 JUNCTION RD RM 1296
MADISON WI
53717-2656
US

IV. Provider business mailing address

316 W WILSON ST APT 1
MADISON WI
53703-4044
US

V. Phone/Fax

Practice location:
  • Phone: 608-265-7700
  • Fax:
Mailing address:
  • Phone: 701-371-9364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: