Individual
MRS. SHAUNNA SHORTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP C
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(559) 289-1063
Mailing address
1054 W 50 S, BLACKFOOT, ID 83221-6088
(559) 289-1063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14920
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
14920
CA
363LF0000X
Family Nurse Practitioner
Primary
14920
CA
363LF0000X
Family Nurse Practitioner
70218
ID
363LP2300X
Primary Care Nurse Practitioner
14920
CA
Other
Enumeration date
09/13/2005
Last updated
02/02/2023
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