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NPI Code Detail

MEDICARE: JORDYN JARRETT NP

MEDICARE: JORDYN JARRETT NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner1971386ID
2207Q00000XFamily Medicine Physician1971386ID

General Provider Information

NPI Number : 1225997133
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDYN JARRETT NP
Provider Business Mailing Address
First Line : 10482 W CARLTON BAY DR
Second Line :
City : GARDEN CITY
State : ID
Zip : 83714-5143
Country : US
Telephone Number : 208-955-6500
Fax Number : 208-955-6501
Provider Business Practice Location Address
First Line : 11197 W FAIRVIEW AVE
Second Line :
City : BOISE
State : ID
Zip : 83713-7935
Country : US
Telephone Number : 208-378-8011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 02/09/2026

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