Individual
JENNIFER LYNNE HOLLIDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
(208) 322-7018
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
(208) 322-7018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MR-0988
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808082100
—
ID
Enumeration date
06/20/2008
Last updated
08/20/2008
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