Individual
SHAUNA L ELLEFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1620 S CELEBRATION AVE, STE 400, MERIDIAN, ID 83642-2779
(208) 884-1030
(208) 884-3058
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-1089A
ID
Other
Enumeration date
08/10/2011
Last updated
12/29/2012
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