Individual
LAURIE NICOLE MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
750 N SYRINGA ST STE 205, POST FALLS, ID 83854-5275
(208) 262-0945
(208) 415-0150
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-770
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093178394
—
ID
Enumeration date
04/04/2016
Last updated
05/02/2019
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