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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JENNY RICKELL WILLMORE, P.A.-C.

Active

JENNY RICKELL WILLMORE, P.A.-C. is a Physician Assistant healthcare provider located in SAINT ANTHONY, Idaho. NPI 1003992140 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · SAINT ANTHONY, ID

Registration Details

NPI Number
1003992140
Provider Type
Individual
Gender
Female
NPI Issued
Oct 31, 2006 (19.78042941291 yrs)
Last Updated
Sep 25, 2012
License
PA-519 (ID)

Practice Information

Address
605 MAPLE AVE
SAINT ANTHONY, ID, 834455529
Browse ID providers · Browse ZIP 83445
Phone
2086244002
Fax
2086244409
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in SAINT ANTHONY, ID

Name Credential NPI
BRYCE DAVID WYLIE PA-C 1811043862
ANDREW LOGAN BROWER PA-C 1760766976
ROBERT CREIGHTON SHUMWAY PA-C, CAQ-PSYCH 1942784756
DANIEL A SQUIRE PA-C 1447734892
RYAN G WILLMORE PA-C 1750840138
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.