NPI 1396335378 · live from the CMS NPI Registry
Katharine Elizabeth De Gennaro
Dietitian, Registered in Boise, ID. National Provider Identifier 1396335378, active.
NPI record
| NPI | 1396335378 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 100 E Idaho St, Boise, ID 83712 |
| Practice phone | 208-381-2711 |
| Mailing address | 190 E Bannock St, Boise, ID 83712 |
| Enumerated | January 22, 2021 |
| Last updated | October 29, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | — |
| Dietitian, Registered primary | 133V00000X | D-1211 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.