NPI 1023260783

Shawna Marie Reynolds, PA

Practitioner Physician Assistant Blackfoot, ID

Practice location

Address: 1441 Parkway Dr, Blackfoot, ID 83221-0000
Phone: (208) 785-2600
Fax: (208) 785-1762

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA778 (ID)

Other Physician Assistant providers in Idaho →

Medical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA-778 (ID)

Registry record

NPI: 1023260783
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Oct 2008
Record last updated: 23 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.