Individual provider · Type 1 NPI

Jared Cannon

Case Management Registered Nurse · Boise, ID

NPI number 1114657202 Active

Practice location

960 S Broadway Ave
Boise, ID 83706-3600

Call (208) 780-6255 Map

Mailing address

420 N James Rd
Columbus, OH 43219-1834

Specialties and licenses

TaxonomyCodeLicense
Case Management Registered Nurse Primary 163WC0400X50699 (ID)

Case Management Registered Nurse: Definition to come...

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About NPI 1114657202

Jared Cannon's National Provider Identifier is 1114657202, issued on Jun 13, 2022. The primary taxonomy on file is Case Management Registered Nurse (163WC0400X), and the practice location is in Boise, ID. The record was last updated on Jun 13, 2022.