NPI 1821656356 · live from the CMS NPI Registry
Ivon Carrillo, RD
Dietitian, Registered in Idaho Falls, ID. National Provider Identifier 1821656356, active.
NPI record
| NPI | 1821656356 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 3910 Washington Pkwy, Idaho Falls, ID 83404 |
| Practice phone | 208-523-1122 |
| Enumerated | May 30, 2019 |
| Last updated | May 30, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.