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General NPI Number Information
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NPI Number | 1326105206
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Entity Type | Individual
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Provider Name | JACKIE J TURNIPSEED-AYMON PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 1000 STATE ST
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City | MCCALL
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State | ID
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Zip | 83638-3704
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Country | US
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Telephone | 208-634-1776
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Fax | 208-634-3873
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Provider Business Mailing Address
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Address Line | 190 E BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83712-6241
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Country | US
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Telephone | 208-634-1776
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Fax | 208-634-3873
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA242
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License Number State | ID
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