Individual provider · Type 1 NPI

Susan B. Clark, MS, RD, LD, CDE

Registered Dietitian · Rexburg, ID

NPI number 1124676663 Active

Practice location

393 E 2nd N
Rexburg, ID 83440-1605

Call (208) 356-5401 Map

Mailing address

450 E Main St
Rexburg, ID 83440-2048

Other practice locations

  • 450 E Main St, Rexburg, ID 83440-2048 · (208) 359-6522

Specialties and licenses

TaxonomyCodeLicense
Registered Dietitian Primary 133V00000XD-393 (ID)

Registered Dietitian: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the…

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About NPI 1124676663

Susan B. Clark, MS, RD, LD, CDE's National Provider Identifier is 1124676663, issued on Aug 28, 2019. The primary taxonomy on file is Registered Dietitian (133V00000X), and the practice location is in Rexburg, ID. The record was last updated on Nov 24, 2025.