Provider Demographics
NPI:1659905941
Name:ROLING, ERIKA (RD, CLC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:ROLING
Suffix:
Gender:F
Credentials:RD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 EMIL ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2311
Mailing Address - Country:US
Mailing Address - Phone:608-283-6426
Mailing Address - Fax:608-283-6374
Practice Address - Street 1:1409 EMIL ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2311
Practice Address - Country:US
Practice Address - Phone:608-283-6426
Practice Address - Fax:608-283-6374
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1725133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered