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General NPI Number Information
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NPI Number | 1407319841
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Entity Type | Individual
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Provider Name | JESSICA ANN HARNISCH-BOYD DO, MPH
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Gender | Female
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 858 COMMERCE DRIVE
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City | SMELTERVILLE
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State | ID
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Zip | 83868
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Country | US
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Telephone | 208-784-4612
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N BRUCE DR
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City | COEUR D ALENE
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State | ID
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Zip | 83814-5801
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Country | US
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Telephone | 208-784-8765
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | O-1429
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License Number State | ID
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