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NPI Code Detail

MEDICARE: ANGELA QUINN YAMRISKA RDN

MEDICARE: ANGELA QUINN YAMRISKA RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133NN1002XNutrition Education Nutritionist3418WI
2133VN1004XPediatric Nutrition Registered Dietitian3418WI
3133VN1006XMetabolic Nutrition Registered Dietitian3418WI
4133VN1101XGerontological Nutrition Registered Dietitian3418WI
5133VN1201XObesity and Weight Management Nutrition Registered Dietitian3418WI
6133N00000XNutritionist3418WI
7133VN1301XOncology Nutrition Registered Dietitian3418WI
8133VN1401XPediatric Critical Care Nutrition Registered Dietitian3418WI
9133VN1501XSports Dietetics Nutrition Registered Dietitian3418WI
10133V00000XRegistered Dietitian3418WI

General Provider Information

NPI Number : 1073149191
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA QUINN YAMRISKA RDN
Provider Business Mailing Address
First Line : 1515 PARK AVE
Second Line :
City : COLUMBUS
State : WI
Zip : 53925-1618
Country : US
Telephone Number : 920-623-2200
Fax Number :
Provider Business Practice Location Address
First Line : 1515 PARK AVE
Second Line :
City : COLUMBUS
State : WI
Zip : 53925-2402
Country : US
Telephone Number : 920-623-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2020
Last Update Date : 01/18/2024

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