Healthcare Provider Details

I. General information

NPI: 1871455469
Provider Name (Legal Business Name): JENNIFER YVONNE ROBINSON CST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 W EMERALD ST
BOISE ID
83704-8205
US

IV. Provider business mailing address

5255 W GROVER ST
BOISE ID
83705-1141
US

V. Phone/Fax

Practice location:
  • Phone: 208-373-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: