IndividualActive
Jared Cannon
NPI 1114657202 · Case Management Registered Nurse · Boise, ID
Provider details
- NPI number
- 1114657202
- Entity type
- Individual
- Primary specialty
- Case Management Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 50699 (ID)
Mailing address
420 N James Rd
Columbus, OH 43219-1834
Registry dates
- Enumerated
- 2022-06-13
- Last updated
- 2022-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.