Shawna Durbin, | |
98 Poplar St, Blackfoot, ID 83221-1758 | |
(208) 785-3722 | |
Not Available |
Full Name | Shawna Durbin |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 98 Poplar St, 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 |
---|---|---|---|
1407277940 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | D-472 (Idaho) | Primary |
Provider Name | Idaho Falls Community Hospital Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1114481447 PECOS PAC ID: 9032441597 Enrollment ID: O20191217002564 |
Mailing Address | Practice Location Address |
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Shawna Durbin, 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-3722 | Shawna Durbin, 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-3722 |
Jan Williamson, RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
Andrea Porter, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 725 Jensen Grove Dr, Blackfoot, ID 83221 Phone: 208-226-4200 | |
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 |