Provider Demographics
NPI:1821463043
Name:AUMEIER, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:AUMEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 N STILSON RD
Mailing Address - Street 2:317
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-5173
Mailing Address - Country:US
Mailing Address - Phone:208-996-6690
Mailing Address - Fax:
Practice Address - Street 1:9976 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9769
Practice Address - Country:US
Practice Address - Phone:208-996-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDMASG-1350OtherCOMMERCIAL