Provider Demographics
NPI:1598305476
Name:WOYAK, KAREN MARIE (RD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:WOYAK
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 1:2940 AMUNDSON ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-3241
Mailing Address - Country:US
Mailing Address - Phone:715-421-3055
Mailing Address - Fax:
Practice Address - Street 1:2940 AMUNDSON ST
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-3241
Practice Address - Country:US
Practice Address - Phone:715-421-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3295-29133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education