Individual
HEATHER R CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST CFA
Contact information
Practice address
2855 E MAGIC VIEW DR, MERIDIAN, ID 83642-6245
(208) 639-4900
Mailing address
2365 W RAINWATER CT, MERIDIAN, ID 83642-1288
(208) 639-4900
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
94981
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94981
CERTIFICATION NUMBER
ID
Enumeration date
01/26/2007
Last updated
07/08/2007
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