Individual
JESSICA LYNN KROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
(208) 302-5155
Mailing address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-14063
ID
207P00000X
Emergency Medicine Physician
R73922
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/28/2011
Last updated
07/24/2024
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