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General NPI Number Information
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NPI Number | 1568310514
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Entity Type | Organization
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Legal Business Name | SWEET PEA IMAGING
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 810 HEARTLAND CT
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City | NAMPA
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State | ID
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Zip | 83686-8155
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Country | US
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Telephone | 208-615-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 N MILWAUKEE ST STE 180
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City | BOISE
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State | ID
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Zip | 83704-0726
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Country | US
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Telephone | 208-615-4858
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Fax |
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Authorized Official
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Title or Position | OWNER / SONOGRAPHER
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Name | KELSEY WIELAND
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Credential | RDMS, AB, BR, OB/GYN
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Telephone | 406-670-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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