| Shawna Durbin, | |
|
98 Poplar St, Blackfoot, ID 83221-1758 | |
| (208) 785-3722 | |
| Not Available |
| Full Name | Shawna Durbin |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 98 Poplar St, 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 |
|---|---|---|---|
| 1407277940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | D-472 (Idaho) | Primary |
| Provider Name | Idaho Falls Community Hospital Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1114481447 PECOS PAC ID: 9032441597 Enrollment ID: O20191217002564 |
| Mailing Address | Practice Location Address |
|---|---|
| Shawna Durbin, 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-3722 | Shawna Durbin, 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-3722 |
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 | |
Andrea Porter, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 725 Jensen Grove Dr, Blackfoot, ID 83221 Phone: 208-226-4200 | |
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 |