Individual
DR. JENNIFER LYNN ANACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
300 MAIN STREET, SUITE 103, BOISE, ID 83702
(208) 287-2299
(208) 287-2298
Mailing address
PO BOX 2663, BOISE, ID 83701
(208) 287-2299
(208) 287-2298
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR997
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010139825
BLUE SHIELD BOISE OFFICE
ID
01
—
000010157936
MERIDRAN OFFICE
ID
01
—
C3548
BLUE CROSS OF IDAHO
—
Enumeration date
02/23/2007
Last updated
07/08/2007
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