Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACKIE HENRY
ActiveJACKIE HENRY is a Athletic Trainer healthcare provider located in RATHDRUM, Idaho. NPI 1639136351 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · RATHDRUM, ID
Registration Details
- NPI Number
- 1639136351
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 27, 2006 (20.328163895098 yrs)
- Last Updated
- Jul 8, 2007
- License
-
AT-258 (ID)
Practice Information
- Address
-
6749 W EDEN CTRATHDRUM, ID, 838586423Browse ID providers · Browse ZIP 83858
- Phone
- 2086872156
- Primary Specialty
-
Athletic Trainer
2255A2300X
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.