Individual
ROBERT PAUL SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
315 E ELM ST STE 100, CALDWELL, ID 83605-4858
(208) 302-7150
(208) 302-7192
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(082) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
202000267NP-PP
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
NP-75863
ID
Other
Enumeration date
03/25/2020
Last updated
02/29/2024
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