Abba, Jerilyn R

Abba, Jerilyn R is an individual health care provider with primary practice located at 933 Newbury St , Ripon WI 54971-1730. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Abba, Jerilyn R can be contacted via phone (920) 748-9495.

Contact Information

Primary practice address
933 Newbury St Ripon WI 54971-1730
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 1004-029 Wisconsin

Profile Details

NPI number 1487725172
LBN Legal business name Abba, Jerilyn R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487725172 NPPES
Wisconsin Other 1004-029 STATE CERTIFICATION NUMBE

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