Backaus, Wendy M

Backaus, Wendy M is an individual health care provider with primary practice located at 711 W Adams St , Black River Falls WI 54615-5052. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Backaus, Wendy M can be contacted via phone (715) 284-5361.

Contact Information

Primary practice address
711 W Adams St Black River Falls WI 54615-5052
Phone: (715) 284-5361
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 3663-29 Wisconsin

Profile Details

NPI number 1962001909
LBN Legal business name Backaus, Wendy M
Credentials RDN
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2020
Last updated Feb 28th, 2023 - about 3 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 1962001909 NPPES
Wisconsin Other 86118957 CDR CERTIFICATION

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