Provider Demographics
NPI:1962487322
Name:SCHAUER-DENNEAU, ROXANNE M (RD,RDN)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:M
Last Name:SCHAUER-DENNEAU
Suffix:
Gender:F
Credentials:RD,RDN
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:M
Other - Last Name:SCHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD,RDN
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:3263 EATON RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-8046
Practice Address - Country:US
Practice Address - Phone:920-433-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1427133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427-029OtherWISCONSIN LICENSE NUMBER
WI816778OtherCOMMISSION ON DIETETIC REGISTRATION
WI20210396OtherCERTIFIED DIABETES EDUCATOR
WI075100093Medicare Oscar/Certification
WIWI1097009Medicare Oscar/Certification
1427-029OtherWISCONSIN LICENSE NUMBER
WIK400186737Medicare Oscar/Certification
WIK400186738Medicare Oscar/Certification
WIP00154624Medicare Oscar/Certification
WI000171900Medicare Oscar/Certification
WI000001Medicare Oscar/Certification
WIK400282498Medicare Oscar/Certification
WIK400186736Medicare Oscar/Certification