Provider Demographics
NPI:1538828256
Name:FORSHEE, WANDA PAULINE (RDN)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:PAULINE
Last Name:FORSHEE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 SW ARUBA BAY
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3425
Mailing Address - Country:US
Mailing Address - Phone:859-512-3160
Mailing Address - Fax:772-758-5296
Practice Address - Street 1:744 SW ARUBA BAY
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3425
Practice Address - Country:US
Practice Address - Phone:859-512-3160
Practice Address - Fax:772-758-5296
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND10900133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management