MISS KELLY KATHLEEN OTOOLE WOOD RDN, LDN
NPI 1790288124
Dietitian, Registered in Boise, ID

Active since March 12, 2018
6126 W STATE ST, BOISE, ID 83703(208) 407-8921(208) 694-7837 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 16, 2022, Apr 24, 2018, Mar 12, 2018 (3 updates tracked since 2018).

About Miss Kelly Kathleen Otoole Wood Rdn, Ldn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS KELLY KATHLEEN OTOOLE WOOD RDN, LDN (NPI 1790288124) is an individual dietitian, registered in Boise, Idaho, licensed in Idaho (D-460) and active in the NPI registry since March 2018. She maintains a secondary practice location in Boise.

NPPES Registry Identity

NPI1790288124
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMISS KELLY KATHLEEN OTOOLE WOODCredential: RDN, LDN
Location Address6126 W STATE STBoise, ID 83703-2741
Mailing Address13447 N 2nd AveBoise, ID 83714-9409 · (208) 407-8921 · Fax (208) 694-7837
Fax(208) 694-7837
Sole ProprietorYes
Enumeration DateMarch 12, 2018
Last NPPES UpdateNovember 28, 20233 updates tracked since enumeration
NPPES CertifiedNovember 28, 2023
NPI 1790288124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License Licensed in ID · D-460
Definition

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 purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

6126 W STATE ST, Boise, ID 83703

Other Names 1

Former Name (1)Miss Kelly Kathleen O'toole Rd, Ld

Secondary Practice Location 1

Location 113447 N 2nd AveBoise, ID 83714-9409 · Phone (208) 407-8921

Accepted Insurance

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
6126 W STATE ST, SUITE 106
BOISE, ID 83703
Counselor (Professional)
6126 W STATE ST
BOISE, ID 83703
Social Worker
6126 W STATE ST, SUITE 310
BOISE, ID 83703
Rehabilitation Counselor
6126 W STATE ST
BOISE, ID 83703
Counselor (Professional)
6126 W STATE ST
BOISE, ID 83703
Social Worker (Clinical)
6126 W STATE ST
BOISE, ID 83703
Counselor (Mental Health)
6126 W STATE ST
BOISE, ID 83703
Counselor (Mental Health)
6126 W STATE ST
BOISE, ID 83703

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790288124, enumerated as an "individual" on March 12, 2018.

The provider is located at 6126 W STATE ST BOISE, ID 83703 and the phone number is (208) 407-8921.

Dietitian, Registered with taxonomy code 133V00000X.

The provider might be accepting Accepts: Moda Health Plan, Inc., PacificSource Health Plans. Please consult your insurance carrier or call the provider to verify.