NPI 1790080893 · live from the CMS NPI Registry
Kelsey Lorraine Bernier, MS, RD, LD, LMT
Dietitian, Registered in Boise, ID. National Provider Identifier 1790080893, active.
NPI record
| NPI | 1790080893 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 305 E Jefferson St, Boise, ID 83712 |
| Practice phone | 208-381-7340 |
| Mailing address | 190 E Bannock St, Boise, ID 83712 |
| Enumerated | January 20, 2011 |
| Last updated | February 21, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist | 225700000X | MAS-403 (ID) |
| Dietitian, Registered primary | 133V00000X | D-1022 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.