Healthcare Provider Details

I. General information

NPI: 1679347892
Provider Name (Legal Business Name): JULIANNE TRUMAN RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIANNE LAROSE RD

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 01/07/2025
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 EASTPARK BLVD
MADISON WI
53718-2002
US

IV. Provider business mailing address

1330 OKEEFFE AVE APT 102
SUN PRAIRIE WI
53590-4229
US

V. Phone/Fax

Practice location:
  • Phone: 608-440-6400
  • Fax:
Mailing address:
  • Phone: 989-859-8679
  • 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: