Individual
JACQUELINE RITA AMENDE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
520 S EAGLE RD STE 1223, MERIDIAN, ID 83642-6355
(208) 706-2244
Mailing address
2523 N ARMSTRONG PL, BOISE, ID 83704-5471
(208) 960-2235
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-999
ID
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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