Provider Demographics
NPI:1235381534
Name:STAGMAN, DARCY ANN (MS, RD, CD)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:ANN
Last Name:STAGMAN
Suffix:
Gender:F
Credentials:MS, RD, CD
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:ANN
Other - Last Name:DICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 UNIVERSITY ROW
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-1311
Practice Address - Country:US
Practice Address - Phone:608-890-5500
Practice Address - Fax:608-890-5016
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI998908133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered