Jackie Henry

Athletic Trainer · Rathdrum, ID

Individual Active NPI

NPI number 1639136351

Practice location

6749 W Eden Ct
Rathdrum, ID 83858-6423
Phone
(208) 687-2156

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NPI record

NPI
1639136351
Entity type
Individual (Type 1)
Enumeration date
April 27, 2006
Last updated
July 13, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X AT-258 ID

About Jackie Henry

Jackie Henry is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 6749 W Eden Ct, Rathdrum, ID 83858-6423. The NPI number 1639136351 was assigned on April 27, 2006 and the record was last updated on July 13, 2026.

Jackie Henry lists a license in the registry: #AT-258 (ID) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jackie Henry?

The NPI number is 1639136351.

What is the phone number of Jackie Henry?

The phone number listed for the practice location is (208) 687-2156.

Where is Jackie Henry located?

6749 W Eden Ct, Rathdrum, ID 83858-6423.

What is the taxonomy code for Jackie Henry?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.