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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1699163170 NPPES
Idaho MEDICAID 1699163170

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