NPI 1164540209 · live from the CMS NPI Registry
Jeannee Diaz, RD
Dietitian, Registered in Boise, ID. National Provider Identifier 1164540209, active.
NPI record
| NPI | 1164540209 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1226 W River St, Boise, ID 83702 |
| Practice phone | 208-311-1155 |
| Mailing address | 6516 W Outlook Dr, Boise, ID 83714 |
| Enumerated | March 27, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | D-146 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.