| Abbigail Jean Sundell, RDN | |
|
775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 | |
| (208) 814-8780 | |
| Not Available |
| Full Name | Abbigail Jean Sundell |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 775 Pole Line Rd W Ste 302, Twin Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023745056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | D-1382 (Idaho) | Primary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
| Provider Name | St Lukes Clinic Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Abbigail Jean Sundell, RDN 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Abbigail Jean Sundell, RDN 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 Ph: (208) 814-8780 |
Shalissa Marie Tomkinson, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 | |
Evelyn Claire Wiltse, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-7212 | |
Emmalee Calvert, Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 | |
Kyli Gough, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 496 Shoup Ave W Ste A, Twin Falls, ID 83301 Phone: 208-814-9182 | |
Sonamarivell Granados, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-4120 Fax: 208-814-4906 | |
Sarah Ann Renaldi, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 |