Bennett, Jessica
Bennett, Jessica is an individual health care provider with primary practice located at 3679 S Shortleaf Ave , Boise ID 83716-8617. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Bennett, Jessica can be contacted via phone (208) 391-3995.Contact Information
Primary practice address
3679 S Shortleaf Ave
Boise ID 83716-8617
Phone: (208) 391-3995
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | 53218 | Idaho |
Profile Details
NPI number | 1699163170 |
---|---|
LBN Legal business name | Bennett, Jessica |
Credentials | Certified Nurse Midwife (CNM) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 6th, 2015 |
Last updated | Aug 26th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699163170 | NPPES |
Idaho | MEDICAID | 1699163170 |
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