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General NPI Number Information
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NPI Number | 1407102056
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Entity Type | Individual
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Provider Name | JENNY MARIE PINSON APRN
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Gender | Female
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 4553 E TIMBERSAW DR
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City | BOISE
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State | ID
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Zip | 83716-7098
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Country | US
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Telephone | 601-880-9571
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Fax |
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Provider Business Mailing Address
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Address Line | 4553 E TIMBERSAW DR
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City | BOISE
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State | ID
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Zip | 83716-7098
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Country | US
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Telephone | 601-880-9571
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN 001404
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 66608
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License Number State | ID
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