| Llc | |
|
212 S 11th St Ste 4b, Coeur D Alene, ID 83814-4000 | |
| (925) 818-9399 | |
| Not Available |
| Full Name | Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 212 S 11th St Ste 4b, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659195857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Angela Konegni |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1912635368 PECOS PAC ID: 1759747348 Enrollment ID: I20250205000740 |
| Mailing Address | Practice Location Address |
|---|---|
| Llc 2915 E Fernan Ct, Coeur D Alene, ID 83814-5803 Ph: (925) 818-9399 | Llc 212 S 11th St Ste 4b, Coeur D Alene, ID 83814-4000 Ph: (925) 818-9399 |
Scott Geyer, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-4000 |
Kimberley S Hall, DIETICIAN Dietitian Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-666-2000 Fax: 208-666-3963 |
Ms. Taylor Zimmerman, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-4000 |
Leah Joy, R.D., IBCLC Dietitian Medicare: Accepting Medicare Assignments Practice Location: 1310 E Birch Ave, Coeur D Alene, ID 83814 Phone: 315-244-0677 |
Amanda Ament, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1090 W Park Pl, Coeur D Alene, ID 83814 Phone: 208-215-2005 Fax: 844-807-3782 |
Marsha A Jones, DIETITIAN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-666-2000 Fax: 208-666-3963 |
Katie J Adrian, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-666-2000 Fax: 208-666-3963 |