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General NPI Number Information
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NPI Number | 1871620435
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Entity Type | Individual
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Provider Name | JEFFREY MICHAEL ALBRECHT PA
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 223 16TH AVE N
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City | NAMPA
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State | ID
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Zip | 83687-4058
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Country | US
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Telephone | 208-466-7869
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Fax | 208-466-5359
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Provider Business Mailing Address
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Address Line | 211 16TH AVE N PO BOX 9
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City | NAMPA
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State | ID
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Zip | 83687-4058
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Country | US
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Telephone | 208-461-7149
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Fax | 208-467-3391
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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 | PA654
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License Number State | ID
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