Individual
PHYLLIS JENN YOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1520 W STATE ST STE 100, BOISE, ID 83702-4084
(208) 947-7700
(208) 947-7701
Mailing address
1520 W STATE ST STE 100, BOISE, ID 83702-4084
(208) 947-7700
(208) 322-7018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MR-0996
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808083200
—
ID
Enumeration date
06/20/2008
Last updated
10/05/2022
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