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General NPI Number Information
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NPI Number | 1952227647
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Entity Type | Individual
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Provider Name | JENNA SUE RANSBOTTOM CCMA
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Gender | Female
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 1660 JOHN ADAMS PKWY
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City | IDAHO FALLS
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State | ID
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Zip | 83401-4360
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Country | US
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Telephone | 208-432-1976
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Fax | 208-278-7956
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Provider Business Mailing Address
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Address Line | 1214 CORNERSTONE DR
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City | IDAHO FALLS
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State | ID
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Zip | 83401-3683
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Country | US
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Telephone | 208-432-1976
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Fax | 208-278-7956
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | Q8P9S7K5
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License Number State | ID
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