NPI Profile for ST LUKES REGIONAL MEDICAL CENTER in BOISE, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X | |||
Dietitian, Registered |
133V00000X | 71 | Registered Dietitian or Nutrition Professional |
| NPI # | 1003295452 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/19/2015 | |
| Last updated | 06/22/2016 - About 10 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ST LUKES REGIONAL MEDICAL CENTER
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