MEDICARE: MADELINE JANELL HOWARD 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
1	133V00000X	Registered Dietitian	368829	WI

General Provider Information

NPI Number	:	1982316097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE JANELL HOWARD RDN

Provider Business Mailing Address
First Line	:	1133 KELLOGG ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54303-3014
Country	:	US
Telephone Number	:	920-309-1747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 KELLOGG ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54303-3014
Country	:	US
Telephone Number	:	920-309-1747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2022
Last Update Date	:	01/29/2025

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