Carol Diane Atchison, RDLD, CSO, CDE, CNSD

Individual provider Active NPI Registered Dietitian · Idaho Falls, ID

NPI 1497997159 · NPPES record last updated Mar 27, 2009

Key facts

NPI
1497997159
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D-278 (ID)
Practice address
5957 W. 33Rd South
Idaho Falls, ID 83402-5682
Phone
(208) 313-1994
Fax
(208) 552-3341
NPI assigned
Mar 27, 2009
Sex
Female
Sole proprietor
Yes

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-278IDMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D-278 ID Yes

Addresses

Primary practice location

5957 W. 33Rd South
Idaho Falls, ID 83402-5682

Mailing address

5957 W. 33Rd South
Idaho Falls, ID 83402-5682
Phone (208) 313-1994

Other providers in Idaho Falls, ID

All providers in Idaho Falls, ID · Registered Dietitian in Idaho

Sources for this page

Verify at the official NPI Registry.