Individual
SIERRA FAITH BLANKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12585 TRINIDAD ST, CALDWELL, ID 83607-5571
(208) 697-3276
Mailing address
12585 TRINIDAD ST, CALDWELL, ID 83607-5571
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
Primary
1040250
ID
2471C3402X
Radiography Radiologic Technologist
1040250
ID
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
1040250
ID
Other
Enumeration date
02/18/2026
Last updated
02/18/2026
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