Provider Demographics
NPI:1912379165
Name:LEMAN, JARAH MIKAYLE (FNP-C)
Entity type:Individual
Prefix:
First Name:JARAH
Middle Name:MIKAYLE
Last Name:LEMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JARAH
Other - Middle Name:MIKAYLE
Other - Last Name:NORDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:100 E IDAHO ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6270
Mailing Address - Country:US
Mailing Address - Phone:208-381-2790
Mailing Address - Fax:
Practice Address - Street 1:100 E IDAHO ST STE 200
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6270
Practice Address - Country:US
Practice Address - Phone:208-381-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7997485-4405363LF0000X
IL209015476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily