NPI 1841970795 · live from the CMS NPI Registry
Susan K Drake, MD, RDN
Dietitian, Registered in Donnelly, ID. National Provider Identifier 1841970795, active.
NPI record
| NPI | 1841970795 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 13158 Hawks Bay Rd, Donnelly, ID 83615 |
| Practice phone | 720-490-9649 |
| Mailing address | Po Box 866, Donnelly, ID 83615 |
| Enumerated | July 24, 2023 |
| Last updated | July 24, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 803604 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.