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General NPI Number Information
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NPI Number | 1215815824
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Entity Type | Organization
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Legal Business Name | IDAHO FRONTIER WELLNESS
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 7 N 4TH ST E STE 102
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City | HOMEDALE
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State | ID
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Zip | 83628-1005
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Country | US
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Telephone | 208-934-1985
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Fax | 208-568-2761
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Provider Business Mailing Address
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Address Line | PO BOX 212
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City | GREENLEAF
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State | ID
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Zip | 83626-0212
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Country | US
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Telephone | 208-934-1985
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Fax | 208-568-2761
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Authorized Official
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Title or Position | OWNER
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Name | BONNIE J HOEWING
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Credential | NP
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Telephone | --
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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