Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHANEL CLARK, RDN, LD
Active Sole ProprietorCHANEL CLARK, RDN, LD is a Registered Dietitian healthcare provider located in INDIAN VALLEY, Idaho. NPI 1609424183 is currently active in the NPPES registry. Verify at CMS.
Registered Dietitian · INDIAN VALLEY, ID
Registration Details
- NPI Number
- 1609424183
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 28, 2019 (6.9198645076342 yrs)
- Last Updated
- Aug 28, 2019
- License
-
D-859 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2278 MORITZ LNINDIAN VALLEY, ID, 836325019Browse ID providers · Browse ZIP 83632
- Phone
- 2088168365
- Primary Specialty
-
Registered Dietitian
133V00000X
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.