Doctor Name: | MRS. LYNNE KINSON |
NPI Number: | 1073859336 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 03050 |
Business Practice Address: | 8506 N Maple St Hayden, ID - 838358274 |
Business Phone Number: | 2087552437 |
Business Fax Number: | |
Mailing Address: | 8506 N Maple St, HAYDEN |
State: | ID |
Postal Code: | 838358274 |
Phone Number: | 2087552437 |
Fax Number: | |
NPI Enumeration Date: | 12/14/2012 |
NPI Last Update Date: | 12/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 03050 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |