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Contact Information

LISA J JOHNSON, RD
113 CROCKED CREEK LANE
STANLEY, ID83278
 Phone: 208-774-2864
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for LISA J JOHNSON · (Female)

NPI # 1811662547
Status Active
Credentials RD (Registered Dietitian)
Entity Individual
Enumeration date 08/13/2021
Last updated 08/13/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • ID License # D-122
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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