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1306006929
SHANNON R VAUGHN
BOISE, ID
NPI
1306006929
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: ID NP870A)
Enumeration Date
2008-06-17
Last Update Date
2012-08-21
Business Address
-- SHANNON R VAUGHN NP
300 E JEFFERSON ST SUITE 101
BOISE, ID 83712-6246
Phone number: 208-322-1680
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Mailing Address
-- SHANNON R VAUGHN NP
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-336-4141
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