NPI 1679391627 · live from the CMS NPI Registry
Suzanne Marie Clark, RDN, LD, CDCES
Dietitian, Registered, Nutrition, Metabolic in Nampa, ID. National Provider Identifier 1679391627, active.
NPI record
| NPI | 1679391627 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Metabolic 133VN1006X |
| Practice location | 16692 N Investor Loop Apt 102, Nampa, ID 83687 |
| Practice phone | 208-406-6042 |
| Enumerated | September 30, 2024 |
| Last updated | September 30, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Metabolic primary | 133VN1006X | 8161378 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.