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General NPI Number Information
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NPI Number | 1184423741
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Entity Type | Individual
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Provider Name | EMILY ANNE WISLER MS, RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 320 E CENTRAL AVE
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City | DECATUR
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State | IL
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Zip | 62521-4665
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Country | US
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Telephone | 217-877-9117
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Fax |
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Provider Business Mailing Address
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Address Line | 514 LAUREN LN
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City | FORSYTH
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State | IL
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Zip | 62535-4009
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Country | US
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Telephone | 217-358-3556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164.010939
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License Number State | IL
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