ABBY JAN WILSON (NPI# 1033544580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033544580 |
| Entity Type | Individual |
| Full Name | ABBY JAN WILSON |
| Other Name | ABBY JAN GUSTAVESON |
| Credential | RD, LD, CDE |
| Practice Address |
957 Hospital Way Bldg D Pocatello ID 83201-5096 |
| Practice Telephone | 2082392070 |
| Mailing Telephone | 2082392070 |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2018-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | D-795 | ID | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | 002152 | IA | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | HOSPITAL NPI# | 1790751055 | 01 |
| IA | HOSPITAL NPI# | 1134168263 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1501 Hiland Ave, Nutrition Services and Diabetes Education Clinic, Burley, ID 833182688 | 2086776577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083195978 | Abby Anne Wilson | Occupational Therapy Assistant | 1619 Whitewater Dr, West Bend, WI 53095-9859 | 2018-08-28 |
| 1851502462 | Abby Elizabeth Wilson | Counselor | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2007-05-24 |
| Street Address |
957 HOSPITAL WAY BLDG D |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467093682 | Stephanie Lynn Fisher | Dietitian, Registered | 1066 Yellowstone Ave Apt 61, Pocatello, ID 83201-4430 | 2019-09-30 |
| 1952812067 | Natalie Chase Christensen | Dietitian, Registered | 444 Hospital Way Ste 701, Pocatello, ID 83201-2744 | 2017-10-16 |
| 1457738478 | Rachel Ewing | Dietitian, Registered | 533 N Hayes Ave, Pocatello, ID 83204-3023 | 2015-04-28 |
| 1710391669 | Tracy Jo Green | Dietitian, Registered | 705 Ebony St, Pocatello, ID 83201-5643 | 2014-06-19 |
| 1043598832 | Tiffany Topliff | Dietitian, Registered | 1684 Glacier St, Pocatello, ID 83201-2209 | 2011-07-27 |
| 1699705087 | Karen Diane Donaldson | Dietitian, Registered | 845 W Center St # 208, Pocatello, ID 83204-4205 | 2006-07-03 |
| 1396221073 | Alyssa Marie Hines | Dietitian, Registered | 921 S 8th Ave Stop 8311, Pocatello, ID 83209-8375 | 2018-07-16 |
| 1144738048 | Jessica Badaracco Griffel | Dietitian, Registered | 990 Cesar Chavez Ave, Pocatello, ID 83209-0001 | 2018-01-14 |
| 1922431345 | Misty A Roberts | Dietitian, Registered | 2302 E Terry St, Pocatello, ID 83201-2733 | 2013-08-21 |
| 1154690543 | Joanna Kelley Davidson | Dietitian, Registered | 777 Hospital Way, Building A, Suite 201, Pocatello, ID 83201-5175 | 2011-12-14 |
| Find all providers in POCATELLO | ||||
Please comment or provide details below to improve the information on ABBY JAN WILSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.