Individual
SHAUNA RANKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27591 PETOLLA RD, WILDER, ID 83676-5740
(208) 375-8427
Mailing address
27591 PETOLLA RD, WILDER, ID 83676-5740
(208) 375-8427
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
72982
ID
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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