Lisa Davis, RDN is a
Dietitian, Registered based in Malad City, Idaho. Lisa Davis is licensed to practice in Utah (license number 12248913-4901) and her current practice location is
5054 S 4600 W, Malad City, Idaho. She can be reached at her office (for appointments etc.) via phone at
(719) 290-8113.
NPI number for Lisa Davis is 1548834013 and her current mailing address is 5054 S 4600 W, Malad City, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1548834013.
Healthcare Provider's Profile
Full Name | Lisa Davis |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 5054 S 4600 W, Malad City, Idaho |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1548834013
- Provider Enumeration Date: 05/18/2021
- Last Update Date: 05/18/2021
Medical Identifiers
Medical identifiers for Lisa Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548834013 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 12248913-4901 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Davis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lisa Davis, RDN 5054 S 4600 W, Malad City, ID 83252-6551 Ph: (719) 290-8113 | Lisa Davis, RDN 5054 S 4600 W, Malad City, ID 83252-6551 Ph: (719) 290-8113 |
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