P Praxis·MD
● Active Type 1 · Individual

Suzanne Marie Clark, RDN, LD, CDCES

Dietitian, Registered·Nampa, ID· NPI 1679391627 · Enumerated 2024 · 1 years on NPI
Clark is 1 of 1 dietitian, registered providers in Nampa and 1 of 5 in Idaho.
NPI age
1 years
Enumerated 2024-09-30
Primary specialty
Dietitian, Registered
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-09-30
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 5 active dietitian, registered providers in Idaho.

NPI age
1 years
↓ 18 yr below median (19 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
0% of peers hold subspecialties

NPI lifetime · 2024 → 2026

2024-09Enumerated in NPPES
2024 2026

Where they practice

Practice location
16692 N Investor Loop Apt 102
Nampa, ID 836875227
📞 2084066042
Mailing address
16692 N Investor Loop Apt 102
Nampa, ID 836875227

Specialties

  • Dietitian, Registered Primary
    A registered dietitian who achieves specialized competency in metabolic nutrition.
    ID license #8161378 taxonomy 133VN1006X

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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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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