Healthcare Provider Details

I. General information

NPI: 1760345581
Provider Name (Legal Business Name): BRITTANEE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 S WHEATFIELD LN
AMMON ID
83406-4603
US

IV. Provider business mailing address

385 S WHEATFIELD LN
AMMON ID
83406-4603
US

V. Phone/Fax

Practice location:
  • Phone: 208-403-7841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: