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NPI Code Detail

MEDICARE: JENNI KAY JENSEN ARNP-C

MEDICARE: JENNI KAY JENSEN ARNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner65339ID

General Provider Information

NPI Number : 1285226084
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNI KAY JENSEN ARNP-C
Provider Business Mailing Address
First Line : PO BOX 6795
Second Line :
City : BOISE
State : ID
Zip : 83707-0795
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 W MAIN ST STE 1460
Second Line :
City : BOISE
State : ID
Zip : 83702-5983
Country : US
Telephone Number : 208-505-1179
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2021
Last Update Date : 02/03/2021

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