Individual
SHAWNEE POWERS KYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADRN
Contact information
Practice address
152 2ND AVE S, TWIN FALLS, ID 83301-6201
(208) 241-1837
Mailing address
4077 SAGE SPRINGS CIR, KIMBERLY, ID 83341-5370
(208) 241-1837
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
48250
ID
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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