Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chanel Clark, RDN, LD

Individual provider Registered Dietitian · NPI 1609424183

Chanel Clark, RDN, LD is a Registered Dietitian in Indian Valley, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2019
What do these letters mean?
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

2278 Moritz Ln
Indian Valley, ID 83632-5019
Phone: (208) 816-8365
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence D-859 (ID)

Record details

NPI number1609424183
Entity typeIndividual (Type 1)
GenderFemale
Credentials RDN , LD
Sole proprietorYes
NPI enumeratedAugust 28, 2019
Last updated in NPPESAugust 28, 2019
Mailing address2278 Moritz Ln, Indian Valley, ID 83632-5019