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Jennifer Grinage, PA-C
Medical Physician Assistant in Lewiston, Idaho
NPI 1396151395

Jennifer Grinage is a Medical Physician Assistant based in Troy, ID and is specialized in Medical. Jennifer Grinage practices in Lewiston, ID and has the professional credentials of PA-C. The NPI Number for Jennifer Grinage is 1396151395 and holds a License No. PA1175 (Idaho).

The current practice location address for Jennifer Grinage is 222 Southway Ave Ste C, Lewiston, ID and can be reached out via phone at 208-792-0111.

Location: 222 Southway Ave Ste C, Lewiston, ID, 83871-9647
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396151395
Provider Name
Jennifer Grinage
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
222 Southway Ave Ste C, Lewiston, ID, 83871-9647
Phone Number
208-792-0111
Fax Number
Provider Enumeration Date
07/10/2014
Last Update Date
12/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1396151395 05 WA
1396151395 05 ID
institution
Provider Business Practice Location Address Details
Address
222 Southway Ave Ste C
City
Lewiston
State
Idaho
Zip
83501-2703
Phone Number
208-792-0111
Fax Number
person
Provider Business Mailing Address Details
Address
222 Southway Ave Ste C
City
Lewiston
State
Idaho
Zip
83501-2703
Phone Number
208-792-0111
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA1175 (Idaho)
Definition
Definition to come...
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