Provider Demographics
NPI:1861723579
Name:SEFFROOD, ERIN ELIZABETH (MS, RD, CSP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:SEFFROOD
Suffix:
Gender:F
Credentials:MS, RD, CSP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:JAHNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:K4/938
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-0001
Mailing Address - Country:US
Mailing Address - Phone:608-261-1746
Mailing Address - Fax:608-263-0510
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:K4/938
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-261-1746
Practice Address - Fax:608-263-0510
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI860674133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1477-29OtherCERTIFIED DIETITIAN