Healthcare Provider Details

I. General information

NPI: 1417757527
Provider Name (Legal Business Name): HEATHER SZILARD HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 MERLIN DR STE 200
IDAHO FALLS ID
83404-7489
US

IV. Provider business mailing address

3345 MERLIN DR STE 200
IDAHO FALLS ID
83404-7489
US

V. Phone/Fax

Practice location:
  • Phone: 208-529-1514
  • Fax: 208-529-4020
Mailing address:
  • Phone: 208-529-1514
  • Fax: 208-529-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number6461170
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: