Provider Demographics
NPI:1518265248
Name:ROWSELL, WENDY J (RD, LD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:ROWSELL
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:J
Other - Last Name:PETERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1007
Mailing Address - Country:US
Mailing Address - Phone:319-467-5271
Mailing Address - Fax:319-356-8674
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1007
Practice Address - Country:US
Practice Address - Phone:319-467-5271
Practice Address - Fax:319-356-8674
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001946133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered