Individual
EVEVANNE HOTTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CNSC
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 318-2138
Mailing address
332 VANBUREN, TWIN FALLS, ID 83301
(208) 241-3160
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-441
ID
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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