Provider Demographics
NPI:1083152094
Name:SCHWENKER, KERI (RDN, LD)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:SCHWENKER
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MERCY DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7303
Mailing Address - Country:US
Mailing Address - Phone:563-588-5549
Mailing Address - Fax:563-588-5521
Practice Address - Street 1:200 MERCY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7303
Practice Address - Country:US
Practice Address - Phone:563-588-5549
Practice Address - Fax:563-588-5521
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001880133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered