Individual
MR. TODD L JENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
Mailing address
3960 E 5500 N, MALAD CITY, ID 83252-6069
(208) 589-8116
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
56066
ID
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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