Healthcare Provider Details

I. General information

NPI: 1306756580
Provider Name (Legal Business Name): KRISTIN JENKINS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 W FRANKLIN RD
BOISE ID
83709-0926
US

IV. Provider business mailing address

5594 W OVERLAND RD
MERIDIAN ID
83642-6414
US

V. Phone/Fax

Practice location:
  • Phone: 208-375-4200
  • Fax:
Mailing address:
  • Phone: 208-871-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1681123
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: