Individual
SHELBY RENEE BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 CLEMENTS LN, REXBURG, ID 83440-5352
(509) 531-2548
Mailing address
1750 CLEMENTS LN, REXBURG, ID 83440-5352
(509) 531-2548
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5071472
ID
390200000X
Student in an Organized Health Care Education/Training Program
76133
ID
390200000X
Student in an Organized Health Care Education/Training Program
RN60557241
WA
Other
Enumeration date
04/02/2025
Last updated
03/30/2026
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