Healthcare Provider Details

I. General information

NPI: 1932038569
Provider Name (Legal Business Name): ABIGAIL RUTH TORRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 E PIONEER DR
OAKLEY ID
83346-7000
US

IV. Provider business mailing address

190 E PIONEER DR
OAKLEY ID
83346-7000
US

V. Phone/Fax

Practice location:
  • Phone: 208-447-6415
  • Fax:
Mailing address:
  • Phone: 208-447-6415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1571093
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3196
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number074.0134935
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: