Provider Demographics
NPI:1043401847
Name:ARGEANAS, SIA (RD LD)
Entity Type:Individual
Prefix:MR
First Name:SIA
Middle Name:
Last Name:ARGEANAS
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 S DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5960
Mailing Address - Country:US
Mailing Address - Phone:208-514-2103
Mailing Address - Fax:208-465-8437
Practice Address - Street 1:824 S DIAMOND ST
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5960
Practice Address - Country:US
Practice Address - Phone:208-514-2103
Practice Address - Fax:208-465-8437
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered