Provider Demographics
NPI:1831391762
Name:BURRI, BARBARA SUE (RD, LD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUE
Last Name:BURRI
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 1:920 MAIN ST
Mailing Address - Street 2:SOUTHWEST DISTRICT HEALTH
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-3748
Mailing Address - Country:US
Mailing Address - Phone:208-455-5333
Mailing Address - Fax:208-454-7722
Practice Address - Street 1:STATE ROUTE 225
Practice Address - Street 2:OWYHEE COMMUNITY HEALTH FACILITY
Practice Address - City:OWYHEE
Practice Address - State:NV
Practice Address - Zip Code:89832
Practice Address - Country:US
Practice Address - Phone:775-757-2415
Practice Address - Fax:775-757-2066
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-080133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered