Individual
INGRID SEVILLA SERRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
623 7TH AVE S, NAMPA, ID 83651-4171
(814) 954-9980
Mailing address
623 7TH AVE S, NAMPA, ID 83651-4171
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4271985
ID
Other
Enumeration date
10/09/2025
Last updated
10/09/2025
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