Church, Leona Jo'Anne'
Church, Leona Jo'Anne' is an individual health care provider with primary practice located at 1655 W Fairview Ave Ste 206 , Boise ID 83702-5190. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Church, Leona Jo'Anne' can be contacted via phone (208) 395-0000.Contact Information
Primary practice address
1655 W Fairview Ave Ste 206
Boise ID 83702-5190
Phone: (208) 395-0000
Fax: (208) 395-0009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | NP-157A | Idaho |
Profile Details
| NPI number | 1073675617 |
|---|---|
| LBN Legal business name | Church, Leona Jo'Anne' |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Apr 23rd, 2009 - about 15 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 | 1073675617 | NPPES |
| Idaho | MEDICAID | 805703400 |
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