NPI 1497215982 · live from the CMS NPI Registry
Janette Sue Cooke
Dietitian, Registered in Mountain Home Afb, ID. National Provider Identifier 1497215982, active.
NPI record
| NPI | 1497215982 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 90 Hope Dr, Mountain Home Afb, ID 83648 |
| Practice phone | 208-828-1238 |
| Mailing address | 5695 S Pepperview Way, Boise, ID 83709 |
| Enumerated | March 21, 2019 |
| Last updated | December 13, 2019 |
| Sole proprietor | Yes |
| Other names | Janette Mcmillin |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | — |
| Dietitian, Registered primary | 133V00000X | 913470 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.