Gracie Michelle Dulick, MS, RDN, CSP, LD | |
190 E Bannock St, Boise, ID 83712-6241 | |
(208) 381-3421 | |
Not Available |
Full Name | Gracie Michelle Dulick |
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Gender | Female |
Speciality | Dietitian, Registered - Nutrition, Pediatric |
Location | 190 E Bannock St, Boise, 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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1194367128 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133VN1004X | Dietitian, Registered - Nutrition, Pediatric | D-1218 (Idaho) | Primary |
Provider Name | University Of Wisconsin Medical Foundation Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
Mailing Address | Practice Location Address |
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Gracie Michelle Dulick, MS, RDN, CSP, LD 3608 S Williamsburg Way, Boise, ID 83706-5604 Ph: () - | Gracie Michelle Dulick, MS, RDN, CSP, LD 190 E Bannock St, Boise, ID 83712-6241 Ph: (208) 381-3421 |
St Luke's Humphreys Diabetes Center Dietitian Medicare: Medicare Enrolled Practice Location: 1226 W River St, Boise, ID 83702 Phone: 208-331-1155 | |
Sav-on Pharmacy Dietitian Medicare: Not Enrolled in Medicare Practice Location: 250 E Parkcenter Blvd, Boise, ID 83706 Phone: 208-395-3963 Fax: 623-336-6363 | |
Natalie Dawn Echanis, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 960 S Broadway Ave Ste 505, Boise, ID 83706 Phone: 208-780-6254 | |
Rachael Tatko, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 13900 W Wainwright Dr, Boise, ID 83713 Phone: 208-433-9424 | |
Daria T Pori, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 500 W Fort St, Boise, ID 83702 Phone: 208-422-1141 | |
Ms. Megan Marie Mcguffey, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1910 University Dr, Boise, ID 83725 Phone: 208-426-1459 | |
Rhonda L O'brien, MS, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1414 W Franklin St, Boise, ID 83702 Phone: 208-342-2228 Fax: 208-343-0889 |