Provider Demographics
NPI:1922868694
Name:NEES, JESLYN MASHELL (BS, MA)
Entity Type:Individual
Prefix:
First Name:JESLYN
Middle Name:MASHELL
Last Name:NEES
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 W PERUGIA ST APT N204
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-5215
Mailing Address - Country:US
Mailing Address - Phone:208-794-2296
Mailing Address - Fax:
Practice Address - Street 1:6305 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3029
Practice Address - Country:US
Practice Address - Phone:208-605-3663
Practice Address - Fax:208-550-3241
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator