| Andrea Porter, RDN | |
|
725 Jensen Grove Dr, Blackfoot, ID 83221-1636 | |
| (208) 226-4200 | |
| Not Available |
| Full Name | Andrea Porter |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 725 Jensen Grove Dr, Blackfoot, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376114389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | D-934 (Idaho) | Primary |
| Provider Name | Bmh Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1255539193 PECOS PAC ID: 8426149758 Enrollment ID: O20071018000897 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Porter, RDN 1206 Danielle Way, Blackfoot, ID 83221-5896 Ph: (120) 822-6420 | Andrea Porter, RDN 725 Jensen Grove Dr, Blackfoot, ID 83221-1636 Ph: (208) 226-4200 |
Stephenie Dee Lords, RD, LD, CDCES Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3867 Fax: 208-782-3981 | |
Jan Williamson, RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
Shawna Durbin, Dietitian Medicare: Medicare Enrolled Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3722 | |
Stephanie Lynn Henderson, RD LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1555 Vernon Ave, Blackfoot, ID 83221 Phone: 307-399-0139 | |
Camile Michaelson, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
Allison Marotz, REGISTERED DIETITIAN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3867 |