Hydee Flishaw Tubbs Becker, RDN
Individual provider Active NPI Registered Dietitian · Moscow, ID
NPI 1831703057 · NPPES record last updated Sep 4, 2020
Key facts
- NPI
- 1831703057
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- D-880 (ID)
- Practice address
- 614 North Hayes Street
Moscow, ID 83843 - Phone
- (952) 607-5050
- NPI assigned
- Sep 4, 2020
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-880 | ID | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D-880 | ID | Yes |
Addresses
Primary practice location
614 North Hayes Street
Moscow, ID 83843
Mailing address
614 North Hayes Street
Moscow, ID 83843
Phone (952) 607-5050
Other names
- Hydee Flishaw Tubbs
Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2020. 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.