Individual
MS. JENNA LYNN MAFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.M.S; PA-C
Contact information
Practice address
11197 W FAIRVIEW AVE, BOISE, ID 83713-7935
(208) 378-8011
(208) 322-8095
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6522
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
60112494
WA
363AM0700X
Medical Physician Assistant
Primary
PA-929
ID
Other
Enumeration date
10/07/2009
Last updated
01/21/2014
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