NPI 1407277940 · live from the CMS NPI Registry
Shawna Durbin
Dietitian, Registered in Blackfoot, ID. National Provider Identifier 1407277940, active.
NPI record
| NPI | 1407277940 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 98 Poplar St, Blackfoot, ID 83221 |
| Practice phone | 208-785-3722 |
| Enumerated | December 31, 2013 |
| Last updated | December 31, 2013 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | D-472 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.