NPI 1689407082 · live from the CMS NPI Registry
Angeliece Nicole Durham, RD
Dietitian, Registered in Filer, ID. National Provider Identifier 1689407082, active.
NPI record
| NPI | 1689407082 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2211 Alex Dr, Filer, ID 83328 |
| Practice phone | 208-830-9631 |
| Enumerated | August 21, 2024 |
| Last updated | August 21, 2024 |
| Sole proprietor | No |
| Other names | Angeliece Guerry |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | D-1391 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.