Provider Demographics
NPI:1740660273
Name:KRAHN, JANAE (MD)
Entity type:Individual
Prefix:
First Name:JANAE
Middle Name:
Last Name:KRAHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANAE
Other - Middle Name:V
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 N RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9251
Mailing Address - Country:US
Mailing Address - Phone:208-514-2500
Mailing Address - Fax:208-375-2217
Practice Address - Street 1:2275 S EAGLE RD STE 120
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2620
Practice Address - Country:US
Practice Address - Phone:208-514-2520
Practice Address - Fax:208-375-2217
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-13481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1740660273Medicaid