Provider Demographics
NPI:1235300245
Name:WANEK, JANET M (RDN)
Entity Type:Individual
Prefix:MISS
First Name:JANET
Middle Name:M
Last Name:WANEK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 HIGHWAY 49 N
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:ND
Mailing Address - Zip Code:58523-6038
Mailing Address - Country:US
Mailing Address - Phone:701-873-4445
Mailing Address - Fax:701-873-4199
Practice Address - Street 1:1312 HIGHWAY 49 N
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:ND
Practice Address - Zip Code:58523-6038
Practice Address - Country:US
Practice Address - Phone:701-873-4445
Practice Address - Fax:701-873-4199
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND976929133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered