NPI 1447744156 · live from the CMS NPI Registry
Clinton Cullins, LDN
Dietitian, Registered in Meridian, ID. National Provider Identifier 1447744156, active.
NPI record
| NPI | 1447744156 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1859 S Topaz Way Ste 100, Meridian, ID 83642 |
| Practice phone | 208-209-2432 |
| Mailing address | 175 E Hawthorn Pkwy Ste 235, Vernon Hills, IL 60061 |
| Enumerated | June 15, 2018 |
| Last updated | June 15, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | D1039 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.