Provider Demographics
NPI:1629177761
Name:DRENGBERG-GILBOE, ANNA M (RD)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:M
Last Name:DRENGBERG-GILBOE
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 1:9427 WHITE FOX LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5649
Mailing Address - Country:US
Mailing Address - Phone:608-280-7033
Mailing Address - Fax:
Practice Address - Street 1:9427 WHITE FOX LN
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-5649
Practice Address - Country:US
Practice Address - Phone:608-280-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI712799133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered