Individual
TONYA JEAN JENOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
420 W MAIN ST STE 206, BOISE, ID 83702-7363
(208) 426-9200
(208) 426-9300
Mailing address
11434 W MONTANA ST, BOISE, ID 83713-1130
(208) 724-4006
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
64546
ID
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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