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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

NPI Number 1487245122
LBN Legal business name IDAHO STATE UNIVERSITY
Authorized official CYNTHIA ROCK - (CLINICS DIRECTOR OF OPERATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 01/26/2021
Last updated 01/26/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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