NPI age
6 years
Enumerated 2019-08-28
● Active
Type 1 · Individual
Chanel Clark, RDN, LD
Clark is 1 of 1 dietitian, registered providers in Indian Valley and 1 of 505 in Idaho.
Primary specialty
Dietitian, Registered
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2019-08-28
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 505 active dietitian, registered providers in Idaho.
NPI age
6 years
≈ at median (7 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
15% of peers hold subspecialties
NPI lifetime · 2019 → 2026
2019-08Enumerated in NPPES
2019
2026
Where they practice
Practice location
2278 Moritz Ln
Indian Valley, ID 836325019
Mailing address
2278 Moritz Ln
Indian Valley, ID 836325019
Specialties
-
Dietitian, Registered PrimaryA 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...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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