MRS. JENNIFER RENEE MACDERMOTT MS RN ACNS-BC NPI 1912219288

NPI Information

NPI: 1912219288
Provider Name: MRS. JENNIFER RENEE MACDERMOTT, MS, RN, ACNS-BC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
190 E BANNOCK ST
BOISE, ID
ZIP 83712
Phone: (208) 381-5015
Get Directions

MRS. Jennifer Renee Macdermott, MS, RN, ACNS-BC is an adult health nurse practitioner in Boise, ID with 15 years of experience. MRS. Jennifer Renee Macdermott, MS, RN, ACNS-BC NPI is 1912219288. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

190 E BANNOCK ST
BOISE, ID
ZIP 83712-241
Phone: (208) 381-5015
Fax: (208) 381-1873

The NPI 1912219288 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/2/2010 and was last updated on 8/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	APRN.CNP.12917	OHIO	No
2	363LA2200X	Nurse Practitioner	Adult Health	60641	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0194314	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »