IndividualActive
Susan Jensen, TT47289
NPI 1114677655 · Pharmacy Technician · Caldwell, ID
Provider details
- NPI number
- 1114677655
- Entity type
- Individual
- Primary specialty
- Pharmacy TechnicianPharmacy Service Providers
- Credential
- TT47289
- Sex
- Female
- Sole proprietor
- Yes
- License
- TT47289 (ID)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
4110 S 10th Ave
Caldwell, ID 83605-5706
Phone: (208) 402-0154
Approximate (ZIP-level) locationGet directions
Mailing address
4110 S 10th Ave
Caldwell, ID 83605-5706
Registry dates
- Enumerated
- 2022-03-27
- Last updated
- 2022-03-27
- Certified
- 2022-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.