Provider Demographics
NPI:1134560949
Name:HAYEK, MARCIA KAY (RD)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:KAY
Last Name:HAYEK
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 1:3801 SPRING STREET
Mailing Address - Street 2:WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405
Mailing Address - Country:US
Mailing Address - Phone:608-687-4480
Mailing Address - Fax:608-687-6344
Practice Address - Street 1:3801 SPRING STREET
Practice Address - Street 2:WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405
Practice Address - Country:US
Practice Address - Phone:262-687-4279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIR5072951174-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered