Individual
JENNI L. BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 E IDAHO ST, STE 400, BOISE, ID 83712-6267
(208) 345-5250
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-9789
ID
Other
Enumeration date
03/21/2007
Last updated
07/24/2013
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