Provider Demographics
NPI:1548042161
Name:HEMMERSBACH, ASHLEY (RDN, CD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HEMMERSBACH
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15370 COUNTY HIGHWAY XX
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:WI
Mailing Address - Zip Code:54648-8279
Mailing Address - Country:US
Mailing Address - Phone:608-823-7228
Mailing Address - Fax:
Practice Address - Street 1:238 FRONT ST
Practice Address - Street 2:
Practice Address - City:CASHTON
Practice Address - State:WI
Practice Address - Zip Code:54619-2002
Practice Address - Country:US
Practice Address - Phone:608-654-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5348-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered