Individual
JENNIFER L ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 S MAIN ST, TROY, ID 83871-5009
(208) 835-5550
(208) 835-5554
Mailing address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 289-3841
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
67523
ID
Other
Enumeration date
04/01/2021
Last updated
10/01/2025
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