Individual
MRS. JEANNETTE E JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 468-5930
(208) 463-3044
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 463-3034
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M8205
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010032978
BLUE SHIELD
ID
01
—
080036991
RAILROAD MEDICARE
ID
01
—
42507
BLUE CROSS
ID
05
—
806061800
—
ID
01
—
806353400
HEALTHY CONNECTIONS
ID
Enumeration date
10/21/2005
Last updated
04/04/2017
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