Healthcare Provider Details
I. General information
NPI: 1538091491
Provider Name (Legal Business Name): OVERLAND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
660 W CAPSTONE CT STE B
HAYDEN ID
83835-8774
US
IV. Provider business mailing address
660 W CAPSTONE CT STE B
HAYDEN ID
83835-8774
US
V. Phone/Fax
- Phone: 208-295-9778
- Fax: 208-213-9369
- Phone: 208-295-9778
- Fax: 208-213-9369
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HEATHER
OVERLAND
Title or Position: DR
Credential: NMD, LAC
Phone: 208-295-9778