Individual
KIRSTEN CEILY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3041 E COPPER POINT DR, MERIDIAN, ID 83642-1740
(208) 381-1593
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1150
ID
133V00000X
Registered Dietitian
Primary
D1150
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1150
IDAHO STATE BOARD OF MEDICINE
ID
Enumeration date
02/24/2020
Last updated
04/24/2026
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