NPI 1205284213 · live from the CMS NPI Registry
Andrea L Bailey, RD, LD
Dietitian, Registered in Boise, ID. National Provider Identifier 1205284213, active.
NPI record
| NPI | 1205284213 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2518 N Lancaster Dr, Boise, ID 83702 |
| Practice phone | 208-991-2066 |
| Enumerated | May 31, 2016 |
| Last updated | January 31, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | ND-11269 (FL) |
| Dietitian, Registered | 133V00000X | L007017 (NC) |
| Dietitian, Registered primary | 133V00000X | D-1027 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.