Mary Ginnetti, LDN

Individual provider Active NPI Registered Dietitian · Meridian, ID

NPI 1154810109 · NPPES record last updated May 4, 2018

Key facts

NPI
1154810109
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D962 (ID)
Practice address
1859 S Topaz Way Ste 100
Meridian, ID 83642-4401
Phone
(208) 209-2432
NPI assigned
May 4, 2018
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D962 ID Yes

Addresses

Primary practice location

1859 S Topaz Way Ste 100
Meridian, ID 83642-4401

Mailing address

175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454
Phone (847) 737-8768

Other providers in Meridian, ID

All providers in Meridian, ID · Registered Dietitian in Idaho

Sources for this page

Verify at the official NPI Registry.