Doctor Name: | HEIDI WINDER |
NPI Number: | 1154795870 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | NP-1654A |
Business Practice Address: | 476 E Chubbuck Rd Chubbuck, ID - 832021816 |
Business Phone Number: | 2082339898 |
Business Fax Number: | 2082328566 |
Mailing Address: | 476 E Chubbuck Rd, CHUBBUCK |
State: | ID |
Postal Code: | 832021816 |
Phone Number: | 2082339898 |
Fax Number: | 2082328566 |
NPI Enumeration Date: | 11/18/2015 |
NPI Last Update Date: | 11/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NP-1654A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |