Individual
JENNIFER ANN LEUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 442-1413
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 442-1413
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
25126
ID
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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