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General NPI Number Information
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NPI Number | 1831041383
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Entity Type | Individual
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Provider Name | KYLEE JOSEPHINE GOOD RD
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Gender | Female
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 900 VITERBO DR
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City | LA CROSSE
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State | WI
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Zip | 54601-8804
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Country | US
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Telephone | 608-796-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 419 ROGERS HILL SPUR
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City | WACO
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State | TX
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Zip | 76705-5742
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Country | US
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Telephone |
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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 | 86359192
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License Number State | TX
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