Individual
MRS. MARY KAYE JENKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-NP-C
Contact information
Practice address
20806 DITTO CREEK RD, OASIS, ID 83647-5034
(208) 796-2119
Mailing address
20806 DITTO CREEK RD, OASIS, ID 83647-5034
(208) 796-2119
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP1347A
ID
Other
Enumeration date
11/21/2013
Last updated
11/21/2013
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