Individual provider · NPI-1

Jenifer Shanon Conn, APRN-CNP

Nurse Practitioner, Adult Health · Nampa, ID

NPI number1467762856
StatusActive
Last updated in NPPESJul 3, 2019

Details

NPI
1467762856
Entity type
Individual (NPI-1)
Name
Jenifer Shanon Conn
Credential
APRN-CNP
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 19, 2010
Last updated
Jul 3, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LA2200X Nurse Practitioner, Adult Health60035IDYes
163WD0400X Registered Nurse, Diabetes EducatorN32302ID

Practice location

1510 12th Avenue Rd Ste 200
Nampa, ID 83686

Phone 208-302-0600 · Fax 208-302-0755

Mailing address

3340 E Goldstone Way
Meridian, ID 83642

Phone 208-302-0600 · Fax 208-302-0755

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