Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kim L Petershack, CD

Individual provider Registered Dietitian · NPI 1346206323

Kim L Petershack, CD is a Registered Dietitian in Madison, Wisconsin. Works from 2 locations. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2006

Practice location Address checks out

1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone: (608) 252-8000
Fax: (608) 283-7192
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1313 Fish Hatchery Rd, Madison, WI 53715-1911 — (608) 252-8000

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 15-029 (WI)

Record details

NPI number1346206323
Entity typeIndividual (Type 1)
GenderFemale
Credentials CD
Sole proprietorNo
NPI enumeratedApril 26, 2006
Last updated in NPPESJanuary 23, 2018
Mailing address1313 Fish Hatchery Rd, Madison, WI 53715-1911

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