IndividualActive
Jessica Bennett, CNM
NPI 1699163170 · Advanced Practice Midwife · Boise, ID
Provider details
- NPI number
- 1699163170
- Entity type
- Individual
- Primary specialty
- Advanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CNM
- Sex
- Female
- Sole proprietor
- No
- License
- 53218 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3679 S Shortleaf Ave
Boise, ID 83716-8617
Phone: (208) 391-3995
Approximate (ZIP-level) locationGet directions
Mailing address
3679 S Shortleaf Ave
Boise, ID 83716-8617
Registry dates
- Enumerated
- 2015-01-06
- Last updated
- 2019-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.