Provider Demographics
NPI:1487096954
Name:WICHERT, JANET E (RD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:E
Last Name:WICHERT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 S M 30
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9312
Mailing Address - Country:US
Mailing Address - Phone:989-343-3224
Mailing Address - Fax:989-343-3215
Practice Address - Street 1:2463 S M 30
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9312
Practice Address - Country:US
Practice Address - Phone:989-343-3224
Practice Address - Fax:989-343-3215
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2013-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered