Emmalee Calvert, | |
801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301-5810 | |
(208) 814-1016 | |
(208) 814-1931 |
Full Name | Emmalee Calvert |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 801 Pole Line Rd W Rm H1155, Twin Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1124754825 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
133V00000X | Dietitian, Registered | D-1380 (Idaho) | Primary |
Provider Name | St Lukes Clinic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
Mailing Address | Practice Location Address |
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Emmalee Calvert, 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Emmalee Calvert, 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301-5810 Ph: (208) 814-1016 |
Abbigail Jean Sundell, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301 Phone: 208-814-8780 | |
Shalissa Marie Tomkinson, Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 | |
Evelyn Claire Wiltse, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-7212 | |
Kyli Gough, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 496 Shoup Ave W Ste A, Twin Falls, ID 83301 Phone: 208-814-9182 | |
Sonamarivell Granados, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-4120 Fax: 208-814-4906 | |
Sarah Ann Renaldi, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 |