Provider Demographics
NPI:1194043356
Name:WENZEL, TAMMY JANE (RD)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:JANE
Last Name:WENZEL
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 1:6909 N JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8217
Mailing Address - Country:US
Mailing Address - Phone:989-689-3162
Mailing Address - Fax:
Practice Address - Street 1:6909 N JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-8217
Practice Address - Country:US
Practice Address - Phone:989-689-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered