Provider Demographics
NPI:1114756749
Name:TAURO LOMBARD, WENDY ANN (RD)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ANN
Last Name:TAURO LOMBARD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-0479
Mailing Address - Country:US
Mailing Address - Phone:207-521-4252
Mailing Address - Fax:269-815-5594
Practice Address - Street 1:2667 LAKE GRASSMERE CIR
Practice Address - Street 2:
Practice Address - City:ZELLWOOD
Practice Address - State:FL
Practice Address - Zip Code:32798-9024
Practice Address - Country:US
Practice Address - Phone:207-521-4252
Practice Address - Fax:269-815-5594
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11395133V00000X
IN37003139A133V00000X
MEDI1053133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered