NPI 1760156152 · live from the CMS NPI Registry
Jennifer Lisa Anthony, RD
Dietitian, Registered, Nutrition, Obesity and Weight Management in Boise, ID. National Provider Identifier 1760156152, active.
NPI record
| NPI | 1760156152 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Obesity and Weight Management 133VN1201X |
| Practice location | 777 N Raymond St, Boise, ID 83704 |
| Practice phone | 208-514-2500 |
| Enumerated | August 9, 2021 |
| Last updated | December 15, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Pediatric | 133VN1004X | — |
| Dietitian, Registered, Nutrition, Obesity and Weight Management primary | 133VN1201X | D-1017 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.