Individual
EMILY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 227-2840
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
O-2027
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2022
Last updated
10/03/2024
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