Search › Idaho › 207PH0002X
Brenna Shackelford, MD
NPI 1033377833 · on the registry since 2008
Practice
- Address
- 520 S Eagle Rd Ste 3102
Meridian, ID 83642 - Phone
- (208) 381-1615
- Fax
- (208) 381-5141
- Organisation at this address
- Woman'S Clinic
Robert M Cahn Md Pa
Gem State Pediatrics
Saltzer Medical Group Pa
Robert L. Davidson, M.D. PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 320
Additional practice sites
- 99 Mdg/Sghq, Fl 2, Rm 2576c, Nellis Afb, NV
- 221 Mahalani St, Wailuku, HI
- 745 W Moana Ln Ste 300, Reno, NV
Registry record
- Primary taxonomy
- 207PH0002X
207PH0002X
- Also registered as
- 207P00000X
207P00000X
207P00000X
207P00000X
207P00000X
390200000X - Licence states on file
- HI, IN, NV, CA, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-08-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho