Individual
DR. KERI LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1521 W ALTURAS ST, BOISE, ID 83702-3419
(650) 388-6286
(208) 343-4051
Mailing address
PO BOX 139, BOISE, ID 83701-0139
(208) 451-5072
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C50592
CA
207Q00000X
Family Medicine Physician
Primary
M-13124
ID
Other
Enumeration date
09/02/2006
Last updated
10/30/2024
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