Individual
MS. STEPHANIE LYNN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
1066 YELLOWSTONE AVE APT 61, POCATELLO, ID 83201-4430
(208) 406-2209
Mailing address
1957 E 17TH ST, IDAHO FALLS, ID 83404-6429
(208) 523-1100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1063
ID
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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