Individual
HEIDI L NANAVATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6590 W NORWOOD DR, BOISE, ID 83704-8765
(208) 506-3665
(208) 534-5056
Mailing address
PO BOX 44464, BOISE, ID 83711-0464
(208) 506-3665
(208) 534-5056
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
65331
ID
363LF0000X
Family Nurse Practitioner
F334833
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02773182
—
NY
05
—
1225613375
—
ID
01
—
236620
LICENSE
NM
Enumeration date
05/24/2006
Last updated
02/23/2022
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