Macdermott, Jennifer Renee

Macdermott, Jennifer Renee is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Macdermott, Jennifer Renee can be contacted via phone (208) 381-5015.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-5015
Fax: (208) 381-1873
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN.CNP.12917 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 60641 Idaho

Profile Details

NPI number 1912219288
LBN Legal business name Macdermott, Jennifer Renee
Credentials MS, RN, ACNS-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2010
Last updated Aug 24th, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1912219288 NPPES
Ohio MEDICAID 0194314

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