Individual
SHASTA MARIE SLAVKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
901 N CURTIS RD, #503, BOISE, ID 83706-1338
(208) 302-4000
(208) 302-4025
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-4000
(208) 302-4025
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
55265
ID
Other
Enumeration date
03/09/2017
Last updated
03/30/2017
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