Provider Demographics
NPI:1588282255
Name:STOKA, CHERI (RDN, CD, CLT)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:STOKA
Suffix:
Gender:F
Credentials:RDN, CD, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14960 W GREENFIELD AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-7009
Mailing Address - Country:US
Mailing Address - Phone:262-226-2046
Mailing Address - Fax:
Practice Address - Street 1:6804 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-1452
Practice Address - Country:US
Practice Address - Phone:414-748-2163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI851008133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management