Jennifer Lisa Anthony, RD
Dietitian, Registered, Nutrition, Obesity and Weight Management in Boise, ID. Individual provider (NPI-1).
NPI number1760156152
StatusActive
Last updated in NPPESDec 15, 2023
Details
- NPI
- 1760156152
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Lisa Anthony
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 9, 2021
- Certification date
- Dec 15, 2023
- Last updated
- Dec 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133VN1201X | Dietitian, Registered, Nutrition, Obesity and Weight Management | D-1017 | ID | Yes |
| 133VN1004X | Dietitian, Registered, Nutrition, Pediatric | – | – |
Practice location
777 N Raymond StBoise, ID 83704-9251
Phone 208-514-2500
Mailing address
777 N Raymond StBoise, ID 83704-9251
Phone 208-514-2500
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