Jennifer Lisa Anthony, RD | |
777 N Raymond St, Boise, ID 83704-9251 | |
(208) 514-2500 | |
Not Available |
Full Name | Jennifer Lisa Anthony |
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Gender | Female |
Speciality | Dietitian, Registered - Nutrition, Obesity And Weight Management |
Location | 777 N Raymond 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 |
---|---|---|---|
1760156152 | NPI | - | NPPES |
1760156152 | Medicaid | ID |
Provider Name | Full Circle Health Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1841490075 PECOS PAC ID: 6709986797 Enrollment ID: O20070924000618 |
Mailing Address | Practice Location Address |
---|---|
Jennifer Lisa Anthony, RD 777 N Raymond St, Boise, ID 83704-9251 Ph: (208) 514-2500 | Jennifer Lisa Anthony, RD 777 N Raymond St, Boise, ID 83704-9251 Ph: (208) 514-2500 |
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