BRENNA MAE SHACKELFORD

MERIDIAN, ID
NPI1033377833
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207PH0002X Emergency Medicine, Hospice and Palliative Medicine
(Licence: ID  M-15461)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: HI  MD19340)
207P00000X Emergency Medicine
(Licence: IN  01067626A)
207P00000X Emergency Medicine
(Licence: NV  23824)
207P00000X Emergency Medicine
(Licence: CA  A133488)
207P00000X Emergency Medicine
(Licence: ID  M15461)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2008-05-28
Last Update Date2024-08-06
Business Address
Dr. BRENNA MAE SHACKELFORD MD
520 S EAGLE RD STE 3102
MERIDIAN, ID 83642-6352
Phone number: 208-381-1615
Mailing Address
Dr. BRENNA MAE SHACKELFORD MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-8752