Individual
MS. SHIRLEY EDNA VANZANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3025 W CHERRY LANE, STE B, MERIDIAN, ID 83642-8531
(208) 302-6400
(208) 302-6455
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-6400
(208) 302-6455
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-1394A
ID
363LA2200X
Adult Health Nurse Practitioner
R090943
MD
Other
Enumeration date
07/30/2007
Last updated
11/10/2016
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