| Doctor Name: | KELLY C O'HERON |
| NPI Number: | 1326062415 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD CD |
| License Number: | 1939 |
| Business Practice Address: | 2720 Plaza Dr Suite 1300a Wausau, WI - 544014158 |
| Business Phone Number: | 7158470024 |
| Business Fax Number: | |
| Mailing Address: | 3000 Westhill Dr, Suite 303 WAUSAU |
| State: | WI |
| Postal Code: | 544013795 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |