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General NPI Number Information
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NPI Number | 1164673968
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Entity Type | Individual
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Provider Name | JENIFER L BARRY MD
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Gender | Female
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 1525 S OWYHEE ST
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City | BOISE
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State | ID
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Zip | 83705-6014
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Country | US
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Telephone | 208-344-8482
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Fax | 208-345-5426
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Provider Business Mailing Address
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Address Line | 1525 S OWYHEE ST
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City | BOISE
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State | ID
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Zip | 83705-6014
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Country | US
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Telephone | 208-344-8482
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Fax | 208-345-5426
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | M11233
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A112311
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M-11233
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License Number State | ID
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