Provider Demographics
NPI:1679183388
Name:HEALTH INNOVATIONS
Entity type:Organization
Organization Name:HEALTH INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:208-417-8842
Mailing Address - Street 1:190 W BURNSIDE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2411
Mailing Address - Country:US
Mailing Address - Phone:208-417-8842
Mailing Address - Fax:833-728-0327
Practice Address - Street 1:190 W BURNSIDE AVE STE C
Practice Address - Street 2:
Practice Address - City:CHUBBUCK
Practice Address - State:ID
Practice Address - Zip Code:83202-2411
Practice Address - Country:US
Practice Address - Phone:208-417-8842
Practice Address - Fax:833-728-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty