MEDICARE: CARA JACKSON

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
1	235Z00000X	Speech-Language Pathologist	TSLP-2578	ID

General Provider Information

NPI Number	:	1295149094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA JACKSON

Provider Business Mailing Address
First Line	:	7894 S DESERT RIDGE AVE
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83716-5825
Country	:	US
Telephone Number	:	406-531-1397
Fax Number	:

Provider Business Practice Location Address
First Line	:	1906 FAIRVIEW AVE STE 330
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-5425
Country	:	US
Telephone Number	:	208-385-3680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2014
Last Update Date	:	01/27/2020

Similar Medicare Providers

1386413540 — TIFFANIE GONZALES OTR/L
Practice Location Address:

1906 FAIRVIEW AVE STE 330
CALDWELL, ID
83605-5425

Practice Phone: 208-385-3680
Practice Fax:

1932263597 — NORCO, INC
Practice Location Address:

1906 FAIRVIEW AVE STE 120
CALDWELL, ID
83605-5425

Practice Phone: 208-402-0100
Practice Fax: 208-402-0103

1013331172 — PAUL JONES
Practice Location Address:

1906 FAIRVIEW AVE STE 350
CALDWELL, ID
83605-5425

Practice Phone: 208-454-9181
Practice Fax:

1467814913 — MOLLY GALLEGOS MA, OTR/L
Practice Location Address:

1906 FAIRVIEW AVE STE 330
CALDWELL, ID
83605-5425

Practice Phone: 208-385-3680
Practice Fax: 208-385-3681

1629508288 — BRANDON HANLEY
Practice Location Address:

1906 FAIRVIEW AVE STE 350
CALDWELL, ID
83605-5425

Practice Phone: 208-505-2101
Practice Fax:

1346720513 — MEGAN NICHOLS
Practice Location Address:

1906 FAIRVIEW AVE STE 330
CALDWELL, ID
83605-5425

Practice Phone: 208-385-3680
Practice Fax:

Directions to “ CARA JACKSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.