Provider Demographics
NPI:1952158024
Name:NORELLI, DEANNA M (RD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:NORELLI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:MARIE
Other - Last Name:LA CROIX NORELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:S72W16300 JANESVILLE RD APT 215
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-9770
Mailing Address - Country:US
Mailing Address - Phone:414-339-2744
Mailing Address - Fax:
Practice Address - Street 1:S72W16300 JANESVILLE RD APT 215
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-9770
Practice Address - Country:US
Practice Address - Phone:414-339-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered