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Contact Information

IDAHO STATE UNIVERSITY
1311 E CENTRAL DR
MERIDIAN, ID83642-7991
 Phone: 208-373-1926
 Fax: 833-499-1813
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Education

133NN1002X
 

Nutrition, Gerontological

133VN1101X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Metabolic

133VN1006X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Obesity and Weight Management

133VN1201X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Oncology

133VN1301X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Renal

133VN1005X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Sports Dietetics

133VN1501X 71 Registered Dietitian or Nutrition Professional
 

Nutritionist

133N00000X
Indicates primary specialty

NPI Profile & details for IDAHO STATE UNIVERSITY · (Female)

NPI # 1487245122
Status Active
Credentials
Entity Individual
Enumeration date 01/26/2021
Last updated 01/26/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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