Jack, Alyssa May

Jack, Alyssa May is an individual health care provider with primary practice located at 1350 Parkway Dr Ste 2 , Blackfoot ID 83221-1657. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jack, Alyssa May can be contacted via phone (208) 782-2410.

Contact Information

Primary practice address
1350 Parkway Dr Ste 2 Blackfoot ID 83221-1657
Phone: (208) 782-2410
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1966 Idaho

Profile Details

NPI number 1598357436
LBN Legal business name Jack, Alyssa May
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2021
Last updated Feb 10th, 2021 - about 4 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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