Individual provider · Type 1 NPI

Joanna Bork

Pediatric Nutrition Registered Dietitian · Boise, ID

NPI number 1740605740 Active

Practice location

100 E Idaho St, Suite 200
Boise, ID 83712-6267

Call (208) 381-7081 Map

Mailing address

624 N Glen Aspen Way
Star, ID 83669-5755

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nutrition Registered Dietitian Primary 133VN1004XD-288 (ID)

Pediatric Nutrition Registered Dietitian: An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, educatio…

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About NPI 1740605740

Joanna Bork's National Provider Identifier is 1740605740, issued on Feb 27, 2014. The primary taxonomy on file is Pediatric Nutrition Registered Dietitian (133VN1004X), and the practice location is in Boise, ID. The record was last updated on Feb 27, 2014.