Heidi Marquart, RD

Individual provider Active NPI Registered Dietitian · Driggs, ID

NPI 1104538511 · NPPES record last updated Dec 19, 2022

Key facts

NPI
1104538511
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D-1291 (ID)
Practice address
120 E Howard St
Driggs, ID 83422-5112
Phone
(083) 546-3172
Fax
(208) 354-6318
NPI assigned
Dec 16, 2022
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)
No

State licenses

LicenseStateTypeSpecialty
D-1291IDMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D-1291 ID Yes

Addresses

Primary practice location

120 E Howard St
Driggs, ID 83422-5112

Mailing address

120 E Howard St
Driggs, ID 83422-5112
Phone (707) 330-4117

Other providers in Driggs, ID

All providers in Driggs, ID · Registered Dietitian in Idaho

Sources for this page

Verify at the official NPI Registry.