Individual
TAI BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3425 MERLIN DR STE 200, IDAHO FALLS, ID 83404-7430
(208) 528-6653
Mailing address
3425 MERLIN DR STE 200, IDAHO FALLS, ID 83404-7430
(208) 528-6653
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/05/2022
Last updated
08/12/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up