| Doctor Name: | JENIFER A. STEWART-GREENE |
| NPI Number: | 1679892335 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 21530 |
| Business Practice Address: | 910 Nw 16th St Ste 101 Fruitland, ID - 836192265 |
| Business Phone Number: | 2084526851 |
| Business Fax Number: | 2084522140 |
| Mailing Address: | 3340 East Goldstone Way, MERIDIAN |
| State: | ID |
| Postal Code: | 836421026 |
| Phone Number: | 2083675170 |
| Fax Number: | 2083675180 |
| NPI Enumeration Date: | 05/20/2010 |
| NPI Last Update Date: | 02/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 21530 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |