NPI 1033377833
Brenna Mae Shackelford, MD
Practice location
- Address
- 520 S Eagle Rd STE 3102, Meridian, ID 83642-6352
- Phone
- (208) 381-1615
- Fax
- (208) 381-5141
- Mailing address
- 190 E Bannock St, Boise, ID 83712-6241
Registered specialties (7)
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
Emergency Medicine Physician
Emergency Medicine Physician
Emergency Medicine Physician
Emergency Medicine Physician
Emergency Medicine Physician
Student in an Organized Health Care Education/Training Program
Registry record
- NPI
- 1033377833
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 28 May 2008
- Record last updated
- 6 Aug 2024
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.