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General NPI Number Information
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NPI Number | 1689490781
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Entity Type | Individual
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Provider Name | DENISE (DEE DEE) MARIE DELKAMP CN
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Gender | Female
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Dates
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Enumeration Date | 11/23/2024
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Last Update Date | 11/23/2024
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Provider Practice Location Address
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Address Line | 1515 DOCTORS CT
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City | WATERTOWN
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State | WI
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Zip | 53094-4101
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Country | US
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Telephone | 920-253-8870
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Fax |
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Provider Business Mailing Address
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Address Line | W3416 BERYL DR
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City | WATERTOWN
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State | WI
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Zip | 53094-9469
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Country | US
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Telephone | 920-253-8870
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 001140
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License Number State | WI
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