Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KODY MICHAEL DUCLOS, RD, LD
ActivePediatric Nutrition · BOISE, ID
Registration Details
- NPI Number
- 1033748124
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 2, 2020 (6.054694340019 yrs)
- Last Updated
- Apr 2, 2020
- Licenses
-
86117056 (ID)86117056 (ID)86117056 (ID)
Practice Information
- Address
-
305 E JEFFERSON STBOISE, ID, 837126231Browse ID providers · Browse ZIP 83712
- Phone
- 2083817081
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
- Additional Specialty
- Pediatric Critical Care Nutrition
- Additional Specialty
- Pediatric Nutrition
Other Pediatric Nutrition Providers in BOISE, ID
| Name | Credential | NPI |
|---|---|---|
| LAURA MARGARET BOQUETTE | R.D., CSR, L.D. | 1659665545 |
| JOANNA BORK | — | 1740605740 |
| ERIN ROELOFS | — | 1942628698 |
| MARIE BAILEY-DABNEY | RD, LD, CNSC | 1558761601 |
| SERENA ARAVE | RD, CNSC, LD | 1225423262 |
| GRACIE MICHELLE DULICK | MS, RDN, CSP, LD | 1194367128 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.