Individual
JERALYN JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
703 S AMERICANA BLVD STE 150, BOISE, ID 83702-4976
(208) 706-6375
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8866
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M6048
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000416300
—
ID
Enumeration date
06/21/2006
Last updated
06/20/2023
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