Gustafson, Jill Reena

Gustafson, Jill Reena is an sole proprietor health care provider with primary practice located at 4948 W Kootenai St Ste 100 , Boise ID 83705-2002. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Gustafson, Jill Reena can be contacted via phone (208) 510-0261.

Contact Information

Primary practice address
4948 W Kootenai St Ste 100 Boise ID 83705-2002
Phone: (208) 510-0261
Fax: (208) 225-4243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 56670 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 56670 Idaho

Profile Details

NPI number 1992224166
LBN Legal business name Gustafson, Jill Reena
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2017
Last updated Mar 9th, 2022 - about 2 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.

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