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General NPI Number Information
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NPI Number | 1851113716
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Entity Type | Individual
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Provider Name | JENNIFER LYNN CANTRELL ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 106 W MISSION AVE
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City | SPOKANE
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State | WA
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Zip | 99201-2337
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Country | US
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Telephone | 909-239-3016
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 BROKEN ARROW RD
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City | COEUR D ALENE
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State | ID
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Zip | 83815-8836
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Country | US
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Telephone | 909-239-3016
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 53657
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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 | AP70015355
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License Number State | WA
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