Andrea Porter, RDN | |
725 Jensen Grove Dr, Blackfoot, ID 83221-1636 | |
(208) 226-4200 | |
Not Available |
Full Name | Andrea Porter |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 725 Jensen Grove Dr, Blackfoot, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376114389 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | D-934 (Idaho) | Primary |
Provider Name | Bmh Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1255539193 PECOS PAC ID: 8426149758 Enrollment ID: O20071018000897 |
Mailing Address | Practice Location Address |
---|---|
Andrea Porter, RDN 1206 Danielle Way, Blackfoot, ID 83221-5896 Ph: (120) 822-6420 | Andrea Porter, RDN 725 Jensen Grove Dr, Blackfoot, ID 83221-1636 Ph: (208) 226-4200 |
Jan Williamson, RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
Shawna Durbin, Dietitian Medicare: Medicare Enrolled Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3722 | |
Stephanie Lynn Henderson, RD LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1555 Vernon Ave, Blackfoot, ID 83221 Phone: 307-399-0139 | |
Camile Michaelson, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
Allison Marotz, REGISTERED DIETITIAN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3867 | |
Kywnynn Madsen, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 |