Susan Marie Ashford Tucker, M.S., R.D.
Individual provider Active NPI Registered Dietitian · Sandpoint, ID
NPI 1740518604 · NPPES record last updated Dec 3, 2009
Key facts
- NPI
- 1740518604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 517257 (MT)
- Practice address
- 1219 Elm St
Sandpoint, ID 83864 - Phone
- (406) 570-8019
- Fax
- (208) 263-9747
- NPI assigned
- Dec 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 517257 | MT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael R Dibenedetto MD PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 517257 | MT | Yes |
Addresses
Primary practice location
1219 Elm St
Sandpoint, ID 83864
Mailing address
1219 Elm St
Sandpoint, ID 83864
Phone (406) 570-8019
Other providers in Sandpoint, ID
- Kristine Armstrong
- Jeanne Marie Arnold
- James Rob Aronow
- Kristin Arvidson
- Ash Tree Wellness, LLC
- Atman Counseling
- Sandra Avy
- Donnamarie Aylward
- Selena Bach
- Anne Marie Baggenstoss
All providers in Sandpoint, 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 Dec 3, 2009. 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.