Individual
SARAH BULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNTP
Contact information
Practice address
1021 DANIELSON RD, GENESEE, ID 83832-9783
(208) 892-4001
Mailing address
1021 DANIELSON RD, GENESEE, ID 83832-9783
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
02/19/2021
Last updated
02/19/2021
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