Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. HEATHER MARIE FUNK, MS, RDN, LDN
ActivePediatric Nutrition · MOUNTAIN HOME AFB, ID
Registration Details
- NPI Number
- 1346665189
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 4, 2014 (12.134339803429 yrs)
- Last Updated
- Feb 27, 2020
- License
-
D-319 (ID)
Practice Information
- Address
-
90 HOPE DR BLDG 6000MOUNTAIN HOME AFB, ID, 836481062Browse ID providers · Browse ZIP 83648
- Phone
- 2088287297
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.