Individual
JENNIFER LEE CARLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
(208) 302-5155
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 887
ID
Other
Enumeration date
01/25/2011
Last updated
11/13/2024
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