Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Proactive Wound Care Id Inc

Organization Podiatrist · NPI 1134928419

Proactive Wound Care Id Inc is a Podiatrist in Fish Haven, Idaho. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2270 Highway 89
Fish Haven, ID 83287-5139
Phone: (801) 815-6862
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1134928419
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hayley Williams — Office Manager · (801) 815-6862
NPI enumeratedMarch 10, 2025
Last updated in NPPESMarch 10, 2025
Certification dateMarch 10, 2025
Mailing addressPo Box 607, Centerville, UT 84014-0607