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NPI Code Detail

MEDICARE: RHONDA L O'BRIEN MS, RD

MEDICARE: RHONDA L O'BRIEN MS, RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianD-218ID

General Provider Information

NPI Number : 1033243019
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHONDA L O'BRIEN MS, RD
Provider Business Mailing Address
First Line : 1414 W FRANKLIN ST
Second Line :
City : BOISE
State : ID
Zip : 83702-5023
Country : US
Telephone Number : 208-342-2228
Fax Number : 208-343-0889
Provider Business Practice Location Address
First Line : 1414 W FRANKLIN ST
Second Line :
City : BOISE
State : ID
Zip : 83702-5023
Country : US
Telephone Number : 208-342-2228
Fax Number : 208-343-0889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 03/23/2014

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