Healthcare Provider Details

I. General information

NPI: 1780542977
Provider Name (Legal Business Name): HEATHER KNAPP RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 E BANNOCK ST
BOISE ID
83712-6241
US

IV. Provider business mailing address

701 MORRISON KNUDSEN PLAZA LN
BOISE ID
83712-5000
US

V. Phone/Fax

Practice location:
  • Phone: 208-381-5337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number33780
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: