Provider Demographics
NPI:1285126334
Name:HERBEL, BARBARA KAY (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:KAY
Last Name:HERBEL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-381-2425
Mailing Address - Fax:
Practice Address - Street 1:9951 W ST LUKES DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-7914
Practice Address - Country:US
Practice Address - Phone:208-467-6700
Practice Address - Fax:208-463-6044
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-220133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered