Amanda Ament, RDN

Individual provider Active NPI Registered Dietitian · Coeur D Alene, ID

NPI 1043837685 · NPPES record last updated Aug 25, 2021

Key facts

NPI
1043837685
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D813 (ID)
Practice address
1090 W Park PL
Coeur D Alene, ID 83814-2785
Phone
(208) 215-2005
Fax
(844) 807-3782
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
D813IDMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D813 ID Yes

Addresses

Primary practice location

1090 W Park PL
Coeur D Alene, ID 83814-2785

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 415-0299

Other identifiers

IdentifierTypeStateIssuer
D813OtherIDLICENSE

Other names

  • Amanda Marlette Former name

Other providers in Coeur D Alene, ID

All providers in Coeur D Alene, ID · Registered Dietitian in Idaho

Sources for this page

Verify at the official NPI Registry.