Idaho Nutrition And Wellness Clinic

LBN: Idaho Nutrition And Wellness Clinic
Idaho Nutrition And Wellness Clinic is an health care organization with primary practice located at 894 E Boise Ave , Boise ID 83706-5122. The organization recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as the primary health care specialty. Idaho Nutrition And Wellness Clinic can be contacted via phone (208) 789-9664, or through Bernier, Kelsey L via phone (208) 789-9664.

Contact Information

Primary practice address
894 E Boise Ave Boise ID 83706-5122
Phone: (208) 789-9664
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bernier, Kelsey L MS, RD, LD, LMT
Phone: (208) 789-9664

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X

Profile Details

NPI number 1790287563
LBN Legal business name Idaho Nutrition And Wellness Clinic
DBA Doing business as
Authorized official Bernier, Kelsey L MS, RD, LD, LMT
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2018
Last updated Dec 16th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790287563 NPPES
Idaho MEDICAID IDTPID011885

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