Jennifer Mahlberg-Grant, APRN
Nurse Practitioner, Women's Health in Eagle, ID. Individual provider (NPI-1).
NPI number1982126686
StatusActive
Last updated in NPPESJan 12, 2021
Details
- NPI
- 1982126686
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Mahlberg-Grant
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 13, 2017
- Certification date
- Jan 12, 2021
- Last updated
- Jan 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LW0102X | Nurse Practitioner, Women's Health | 53418 | ID | Yes |
| 363L00000X | Nurse Practitioner | APRN002287 | NV |
Practice location
951 E Plaza DrSte 110
Eagle, ID 83616-6567
Phone 775-738-5850 · Fax 775-738-5856
Mailing address
3325 Research WayCarson City, NV 89706-7913
Phone 775-888-6610 · Fax 775-888-4904
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.