Broekema, Wendy

Broekema, Wendy is an sole proprietor health care provider with primary practice located at 4602 Eastpark Blvd , Madison WI 53718-2002. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Other Service Providers / Health Educator. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Broekema, Wendy can be contacted via phone (608) 263-1530.

Contact Information

Primary practice address
4602 Eastpark Blvd Madison WI 53718-2002
Phone: (608) 263-1530
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X
Other Service Providers / Health Educator 174H00000X 146635 Wisconsin
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 3313 Wisconsin

Profile Details

NPI number 1538542733
LBN Legal business name Broekema, Wendy
Credentials MS, RDN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2015
Last updated Dec 16th, 2020 - about 5 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 1538542733 NPPES
Wisconsin Other 3313 CERTIFIED DIETITIAN
Wisconsin Other 1002101 CERTIFIED DIETITIAN

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