Individual
KYLEE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1411 FALLS AVE E STE 1002, TWIN FALLS, ID 83301-3459
(208) 595-5424
Mailing address
147 W CHUBBUCK RD, CHUBBUCK, ID 83202-2314
(208) 238-7546
(208) 237-9643
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/16/2018
Last updated
08/10/2023
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