Individual
STACY BEESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9850 W ST LUKES DR STE 327, NAMPA, ID 83687-7912
(208) 331-1155
(208) 383-0190
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1071188
ID
133V00000X
Registered Dietitian
810997
CO
Other
Enumeration date
02/03/2014
Last updated
10/28/2025
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