Provider Demographics
NPI:1710359351
Name:SCHLEIGER, SAMANTHA ROSEMARY (MS, RD, CD)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:ROSEMARY
Last Name:SCHLEIGER
Suffix:
Gender:F
Credentials:MS, RD, CD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ROSEMARY
Other - Last Name:KRUEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W3022 WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-4424
Mailing Address - Country:US
Mailing Address - Phone:262-374-1145
Mailing Address - Fax:
Practice Address - Street 1:W3022 WEAVER RD
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-4424
Practice Address - Country:US
Practice Address - Phone:262-374-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI86026697133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered