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General NPI Number Information
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NPI Number | 1184567091
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Entity Type | Individual
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Provider Name | JENNIFER NESBITT PNP
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Gender | Female
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 3280 E LANARK DR
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City | MERIDIAN
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State | ID
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Zip | 83642-5982
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Country | US
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Telephone | 208-377-4400
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Fax | 208-377-4416
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Provider Business Mailing Address
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Address Line | PO BOX 191050
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City | BOISE
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State | ID
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Zip | 83719-1050
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Country | US
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Telephone | 208-955-6500
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Fax | 208-955-6501
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 58871710
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5881710
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.542425
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License Number State | OH
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