Provider Demographics
NPI:1588872717
Name:STEINER, JENNIFER ANNETTE (PT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNETTE
Last Name:STEINER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 W PALMER DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-8390
Mailing Address - Country:US
Mailing Address - Phone:208-461-2905
Mailing Address - Fax:
Practice Address - Street 1:600 ROBBINS RD
Practice Address - Street 2:IERH
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4539
Practice Address - Country:US
Practice Address - Phone:208-489-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP.T.#1633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP.T. # 1633OtherID STATE P.T. NUMBER