1. Home
  2. Directory
  3. Idaho
  4. Middleton
  5. Physician Assistant
  6. NPI Profile

MRS. JENNICE M CORDOVA PA-C
NPI 1609856079
Physician Assistant - Medical in Middleton, ID

Active since January 20, 2006
201 S 1ST AVE E, MIDDLETON, ID 83644(208) 585-6311(208) 585-6221 Get Directions Write a Review

NPPES record last updated: February 12, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Jennice M Cordova Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JENNICE M CORDOVA PA-C (NPI 1609856079) is an individual medical provider in Middleton, Idaho, licensed in Idaho (PA-281) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1609856079
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. JENNICE M CORDOVACredential: PA-C
Location Address201 S 1ST AVE EMiddleton, ID 83644-5809
Mailing Address2165 Aspen Cove DrMeridian, ID 83642-6517 · (208) 288-2548
Phone(208) 585-6311
Fax(208) 585-6221
Sole ProprietorNo
Enumeration DateJanuary 20, 2006
Last NPPES UpdateFebruary 12, 2008
✔ NPI 1609856079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in ID · PA-281
201 S 1ST AVE E, Middleton, ID 83644
Open in Google Maps ↗

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEVERLEE K FURNER NP
Nurse Practitioner
201 S 1ST AVE E
MIDDLETON, ID 83644
Canyon County (208) 585-0048
MR. STEVEN B OLLIE M.D.
Family Medicine
201 S 1ST AVE E
MIDDLETON, ID 83644
Canyon County (208) 585-6311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennice Cordova's NPI number?

The NPI number for Jennice Cordova is 1609856079. It was assigned to this individual provider in the NPPES registry on January 20, 2006.

Where is Jennice Cordova located?

Jennice Cordova practices at 201 S 1st Ave E, Middleton, ID 83644. The listed phone number is (208) 585-6311.

What is Jennice Cordova's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Jennice Cordova was last updated on February 12, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.