Banta, Tai

Banta, Tai is an individual health care provider with primary practice located at 14107 N 5Th E , Idaho Falls ID 83401-5105. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Banta, Tai can be contacted via phone (208) 881-7462.

Contact Information

Primary practice address
14107 N 5Th E Idaho Falls ID 83401-5105
Phone: (208) 881-7462
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Idaho

Profile Details

NPI number 1467185843
LBN Legal business name Banta, Tai
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2022
Last updated Oct 14th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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