Provider Demographics
NPI:1750529269
Name:BRIGGS, JENNIFER LYNN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-4965
Mailing Address - Fax:208-625-4966
Practice Address - Street 1:1300 E MULLAN AVE STE 1600
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6054
Practice Address - Country:US
Practice Address - Phone:208-625-4965
Practice Address - Fax:208-625-4966
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2742363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19979550Medicaid
1750529269OtherNPI
ID1366637068Medicaid
COP00719386OtherRAILROAD MEDICARE