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Search › Idaho › 133V00000X

Jordan Dansereau, RDN, IBCLC

NPI 1992428809 · on the registry since 2022 · sole proprietor

Practice

Address
8500 N Atlas Rd
Hayden, ID 83835
Phone
(208) 415-5284
Organisation at this address
Public Health District 1
Public Health District 1
Public Health District 1
Panhandle Health District
Id Dept Of Health & Welfare Cshp (Hd1)
Inferred from a shared address, not stated in the registry.
Clinicians at this address
11

Registry record

Primary taxonomy
133V00000X
133V00000X
Also registered as
174N00000X
Licence states on file
NULL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-06-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho