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Kody Michael Duclos, RD,LD
Pediatric Nutrition Registered Dietitian in Boise, Idaho
NPI 1033748124

Kody Michael Duclos is a Pediatric Nutrition Registered Dietitian based in Boise, ID and is specialized in Nutrition, Pediatric. Kody Michael Duclos practices in Boise, ID and has the professional credentials of RD,LD. The NPI Number for Kody Michael Duclos is 1033748124 and holds a License No. 86117056 (Idaho).

The current practice location address for Kody Michael Duclos is 305 E Jefferson St, Boise, ID and can be reached out via phone at 208-381-7081. You can also correspond with Kody Michael Duclos through the mailing address at 5176 W MERCURY CT, BOISE, ID - 83705-3746 (mailing address contact number: 208-507-5656).

Location: 305 E Jefferson St, Boise, ID, 83705-3746
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033748124
Provider Name
Kody Michael Duclos
Credential
RD,LD
Provider Entity Type
Individual
Gender
Male
Address
305 E Jefferson St, Boise, ID, 83705-3746
Phone Number
208-381-7081
Fax Number
Provider Enumeration Date
04/02/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
86117056 01 ID COMMISSION ON DIETETIC REGISTRATION
institution
Provider Business Practice Location Address Details
Address
305 E Jefferson St
City
Boise
State
Idaho
Zip
83712-6231
Phone Number
208-381-7081
Fax Number
person
Provider Business Mailing Address Details
Address
5176 W Mercury Ct
City
Boise
State
Idaho
Zip
83705-3746
Phone Number
208-507-5656
Fax Number
person
Provider's Taxonomy Details 1
Type
Dietary & Nutritional Service Providers
Classification
Dietitian, Registered
Speciality
Nutrition, Pediatric
Taxonomy
133VN1004X
License No.
86117056 (Idaho)
Definition
An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.
person
Provider's Taxonomy Details 2
Type
Dietary & Nutritional Service Providers
Classification
Dietitian, Registered
Speciality
Nutrition, Oncology
Taxonomy
133VN1301X
License No.
86117056 (Idaho)
Definition
An individual who is a Board Certified Specialist in Oncology Nutrition and provides direct nutrition care for individuals at risk for or diagnosed with cancer. RDNs working directly with individuals at risk for, or diagnosed with, any type of malignancy or pre-malignant condition, in a variety of settings (e.g. hospitals, clinics, cancer centers, hospices, public health), OR indirectly through roles in management, education, industry, and research practice linked specifically to oncology nutrition. RDN who works indirectly with oncology nutrition through roles in management, education, industry, and research.
person
Provider's Taxonomy Details 3
Type
Dietary & Nutritional Service Providers
Classification
Dietitian, Registered
Speciality
Nutrition, Pediatric Critical Care
Taxonomy
133VN1401X
License No.
86117056 (Idaho)
Definition
An individual who is a Board Certified Specialist in Pediatric Critical Care Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for critically ill infants, children and adolescents. Additional roles could include coordination, education, quality improvement, or research linked specifically to pediatric critical care nutrition.
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