Provider Demographics
NPI:1992059125
Name:HORROCKS, CINDY KAY (RD, LD, CDE)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:KAY
Last Name:HORROCKS
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N CURTIS RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1337
Mailing Address - Country:US
Mailing Address - Phone:208-367-7382
Mailing Address - Fax:208-367-7316
Practice Address - Street 1:1000 N CURTIS RD
Practice Address - Street 2:SUITE 305
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1337
Practice Address - Country:US
Practice Address - Phone:208-367-7382
Practice Address - Fax:208-367-7316
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-062133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered