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General NPI Number Information
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NPI Number | 1609653120
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Entity Type | Individual
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Provider Name | MISS JENNIFER MARIE ENGLISH
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Gender | Female
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 3402 FRANKLIN RD
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City | CALDWELL
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State | ID
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Zip | 83605-6932
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Country | US
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Telephone | 208-573-0531
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Fax |
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Provider Business Mailing Address
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Address Line | 3864 N CHOCAYA PL
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City | MERIDIAN
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State | ID
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Zip | 83646-5897
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Country | US
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Telephone | 208-272-1548
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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