Provider Demographics
NPI:1609329788
Name:ZUNINO, DIANNA (RD, LD)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:ZUNINO
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 1:84 B N 1150 W
Mailing Address - Street 2:
Mailing Address - City:PAUL
Mailing Address - State:ID
Mailing Address - Zip Code:83347
Mailing Address - Country:US
Mailing Address - Phone:280-260-1264
Mailing Address - Fax:
Practice Address - Street 1:84 N 1150 W
Practice Address - Street 2:
Practice Address - City:PAUL
Practice Address - State:ID
Practice Address - Zip Code:83347-8603
Practice Address - Country:US
Practice Address - Phone:208-260-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-749133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered