NPI 1093586158

Brady Kyle Shepherd

Practitioner Certified Registered Nurse Anesthetist Pocatello, ID

Practice location

Address: 777 Hospital Way, Pocatello, ID 83201-5175
Phone: (208) 239-1000
Mailing address: 3443 W Hamm Ln, Herriman, UT 84096-2110

Registered specialties (2)

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 78781 (ID)

Other Nurse Anesthetist, Certified Registered providers in Idaho →

Registered Nurse

Nursing Service Providers Taxonomy 163W00000X Licence 10256717-3102 (UT)

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Registry record

NPI: 1093586158
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jan 2024
Record last updated: 8 Mar 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.