NPI 1669936035 · live from the CMS NPI Registry
Stephanie Carlson
Dietitian, Registered in Post Falls, ID. National Provider Identifier 1669936035, active.
NPI record
| NPI | 1669936035 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 5237 W Citruswood Dr, Post Falls, ID 83854 |
| Practice phone | 208-819-5974 |
| Enumerated | January 29, 2019 |
| Last updated | January 29, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | D920 (ID) |
| Dietitian, Registered primary | 133V00000X | DI60659113 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.