Individual
JESSICA LITKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(916) 215-2148
Mailing address
4650 E TANOAK DR, BOISE, ID 83716-7032
(916) 215-2148
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6817
ID
1835P1200X
Pharmacotherapy Pharmacist
Primary
P6817
ID
Other
Enumeration date
06/30/2014
Last updated
03/05/2026
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