NPI 1104328897
Shallece Jacobs
Practice location
- Address
- 419 N 11th St, Boise, ID 83702-5332
- Phone
- (208) 344-5502
- Fax
- (888) 965-4924
- Mailing address
- 1177 W State St, Boise, ID 83702-5346
Registered specialties
Health Educator
Primary
Registry record
- NPI
- 1104328897
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 8 Mar 2018
- Record last updated
- 8 Mar 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.