Lynda J Anderson-Fisk, DIETICIAN

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

NPI 1477547578 · NPPES record last updated Feb 23, 2010

Key facts

NPI
1477547578
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D116 (ID)
Practice address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone
(208) 666-2000
Fax
(208) 666-3963
NPI assigned
Sep 2, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
D116IDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D116 ID Yes

Addresses

Primary practice location

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 666-2000

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.