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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. LISA ANNE WYCKOFF, RD, CSR, LD

Active Sole Proprietor

MRS. LISA ANNE WYCKOFF, RD, CSR, LD is a Renal Nutrition healthcare provider located in CRYSTAL RIVER, Florida. NPI 1396890273 is currently active in the NPPES registry. Verify at CMS.

Renal Nutrition · CRYSTAL RIVER, FL

Registration Details

NPI Number
1396890273
Provider Type
Individual
Gender
Female
NPI Issued
Jan 24, 2007 (19.365563806557 yrs)
Last Updated
Jul 8, 2007
License
ND2626 (FL)
Sole Proprietor
Yes

Practice Information

Address
7415 W GULF TO LAKE HWY
CRYSTAL RIVER, FL, 344297834
Browse FL providers · Browse ZIP 34429
Phone
3527951415
Fax
3525640147
Primary Specialty
Renal Nutrition
133VN1005X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.