| Elena Jacobs, | |
|
9858 W State St, Star, ID 83669-5210 | |
| (208) 286-9471 | |
| Not Available |
| Full Name | Elena Jacobs |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 9858 W State St, Star, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316617681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 1871747 (Idaho) | Primary |
| Entity Name | Owyhee Family Medicine Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245910470 PECOS PAC ID: 2769825900 Enrollment ID: O20240205003399 |
| Mailing Address | Practice Location Address |
|---|---|
| Elena Jacobs, 9858 W State St, Star, ID 83669-5210 Ph: () - | Elena Jacobs, 9858 W State St, Star, ID 83669-5210 Ph: (208) 286-9471 |
Mrs. Erica Jo Wright, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10542 W Stonecrop Dr, Star, ID 83669 Phone: 208-830-1368 | |
Erika Johnstone, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 307 S Long Bay Way, Star, ID 83669 Phone: 425-802-7193 | |
Sherry Lynn Stanton, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9858 W State St, Star, ID 83669 Phone: 208-286-9471 Fax: 208-286-0565 | |
Kayla Marie Woods, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2500 N Lithodora Ave, Star, ID 83669 Phone: 559-356-6696 |