Stephanie Carlson
Individual provider Active NPI Registered Dietitian · Post Falls, ID
NPI 1669936035 · NPPES record last updated Jan 29, 2019
Key facts
- NPI
- 1669936035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DI60659113 (WA)
- Practice address
- 5237 W Citruswood Dr
Post Falls, ID 83854-5198 - Phone
- (208) 819-5974
- NPI assigned
- Jan 29, 2019
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| D920 | ID | MD | Registered Dietitian |
| DI60659113 | WA | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D920 | ID | |
| Registered Dietitian | 133V00000X | DI60659113 | WA | Yes |
Addresses
Primary practice location
5237 W Citruswood Dr
Post Falls, ID 83854-5198
Mailing address
5237 W Citruswood Dr
Post Falls, ID 83854-5198
Other providers in Post Falls, ID
- Care Essentials
- Caremed Healthcare Services PLLC
- Caritas Christi Communications, LLC
- Brandon Bert Carlson
- Casey Lynn Carlson
- Nicholas Caron
- Christina Carroll
- Mary Kate Carugati
- Alexander James Caten
- CBR PHP & Iop LLC
All providers in Post Falls, ID · Registered Dietitian in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.