Individual
ELISABETH STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
805 N 6TH E, MOUNTAIN HOME, ID 83647-2207
(208) 587-2450
(208) 587-2451
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1463
ID
133V00000X
Registered Dietitian
—
ID
Other
Enumeration date
02/13/2023
Last updated
08/20/2025
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