Provider Demographics
NPI:1982127841
Name:MULTHAUF, KRISTY PESCHEL (MS RD CD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:PESCHEL
Last Name:MULTHAUF
Suffix:
Gender:F
Credentials:MS RD CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16055 SMITH DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3512
Mailing Address - Country:US
Mailing Address - Phone:262-309-8492
Mailing Address - Fax:
Practice Address - Street 1:19333 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4132
Practice Address - Country:US
Practice Address - Phone:262-785-2155
Practice Address - Fax:262-785-2410
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered