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Dr. BRENNA MAE SHACKELFORD MD

Individual Provider (NPI-1) Active

Emergency Medicine, Hospice and Palliative Medicine

Provider Information

NPI Number
1033377833
Provider Type
Individual Provider (NPI-1)
Credentials
MD
Status
Active

Contact & Location

Address
520 S EAGLE RD STE 3102, MERIDIAN, ID, 836426352
Phone
(208) 381-1615
Fax
(208) 381-5141

Specialties & Taxonomies

Emergency Medicine License: HI #MD19340
Emergency Medicine License: IN #01067626A
Emergency Medicine License: NV #23824
Emergency Medicine License: CA #A133488
Emergency Medicine License: ID #M15461
Student in an Organized Health Care Education/Training Program
Emergency Medicine, Hospice and Palliative Medicine Primary License: ID #M-15461

All Addresses

MAILING

190 E BANNOCK ST

BOISE, ID, 837126241

(208) 381-8752

LOCATION

520 S EAGLE RD STE 3102

MERIDIAN, ID, 836426352

(208) 381-1615