Organization
GEM INFANT NUTRIITON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICHOLE RUTH CORTEZ RD (OWNER)
(208) 266-9970
Entity
Organization
Contact information
Practice address
13622 BASCOM ST, CALDWELL, ID 83607-9034
(224) 717-4388
Mailing address
13622 BASCOM ST, CALDWELL, ID 83607-9034
(224) 717-4388
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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