Individual
RACHEL ELIZABETH HENEGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 N 1ST ST STE 280, BOISE, ID 83702-6132
(208) 345-6545
(208) 345-1213
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
63855
MN
208600000X
Surgery Physician
Primary
M-17496
ID
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01086105A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300053478
—
IN
05
—
M-17496
—
ID
Enumeration date
05/04/2012
Last updated
01/30/2024
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