NPI 1871867879 · live from the CMS NPI Registry
Mary M Bosco, RD
Dietitian, Registered in Meridian, ID. National Provider Identifier 1871867879, active.
NPI record
| NPI | 1871867879 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 3250 W Cherry Lane, Meridian, ID 83642 |
| Practice phone | 208-367-6127 |
| Mailing address | 3340 E Goldstone Way, Meridian, ID 83642 |
| Enumerated | March 8, 2012 |
| Last updated | August 6, 2013 |
| Sole proprietor | No |
| Other names | Mary Paul |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | 852745 (CA) |
| Dietitian, Registered primary | 133V00000X | D-751 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.