Provider Demographics
NPI:1356686406
Name:HEWITT, MARGARET (RDN, CD, CDE)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:RDN, CD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S1116 W REDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LA VALLE
Mailing Address - State:WI
Mailing Address - Zip Code:53941-9297
Mailing Address - Country:US
Mailing Address - Phone:608-985-8732
Mailing Address - Fax:
Practice Address - Street 1:1050 DIVISION ST
Practice Address - Street 2:
Practice Address - City:MAUSTON
Practice Address - State:WI
Practice Address - Zip Code:53948-1931
Practice Address - Country:US
Practice Address - Phone:608-847-1293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2858-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered