Individual
JARED WENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2235
(208) 381-4556
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9071990
ID
390200000X
Student in an Organized Health Care Education/Training Program
STUDENT
—
Other
Enumeration date
02/26/2018
Last updated
02/03/2026
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