Individual
BARRY JON SHINSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-6458
Mailing address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-6458
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
74512
ID
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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