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Stormi Niemann

Dietitian, Registered in Boise, ID. Individual provider (NPI-1).

NPI number1053010397
StatusActive
Last updated in NPPESMay 15, 2023

Details

NPI
1053010397
Entity type
Individual (NPI-1)
Name
Stormi Niemann
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 27, 2023
Certification date
May 15, 2023
Last updated
May 15, 2023

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - REGISTERED DIETITIAN OR NUTRITION PROFESSIONA
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, RegisteredD-1328IDYes
133V00000X Dietitian, Registered86290639–

Practice location

305 E Jefferson St
Boise, ID 83712-6231

Phone 208-381-7081

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice locations

1012 N 28th St
Boise, ID 83702-2205

Phone 702-845-1731

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Registered Dietitian providers in Boise, ID

All 148 Registered Dietitian providers in Boise · All 12,265 providers in Boise

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