Knutson, Heather Nicole

Knutson, Heather Nicole is an individual health care provider with primary practice located at 1605 E Riverside Drive , Eagle ID 83616-6237. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Knutson, Heather Nicole can be contacted via phone (208) 939-6227.

Contact Information

Primary practice address
1605 E Riverside Drive Eagle ID 83616-6237
Phone: (208) 939-6227
Fax: (208) 939-6442
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X NP672A Idaho

Profile Details

NPI number 1215936034
LBN Legal business name Knutson, Heather Nicole
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Nov 3rd, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1215936034 NPPES
Idaho Other P00748833 RAILROAD MEDICARE 08/01/09
Idaho Other NP 672A RAILROAD MEDICARE 08/01/09

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