Individual
JACKIE J TURNIPSEED-AYMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 STATE ST, MCCALL, ID 83638-3704
(208) 634-1776
(208) 634-3873
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 634-1776
(208) 634-3873
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA242
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010155539
BLUE CROSS OF IDAHO
—
Enumeration date
01/02/2007
Last updated
01/04/2013
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