Brenda J Shaw in Idaho Falls - Physician Assistant
Brenda J Shaw - NPI 1679642037
Brenda J Shaw is a Physician Assistant in Idaho Falls, Idaho. Brenda J Shaw practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Brenda J Shaw is 1679642037. The last update date is 2009-12-15.
Brenda J Shaw's current location address is 1660 John Adams Pkwy, Idaho Falls, Idaho. You can contact this provider via phone number 2085238844 and fax number 2085298684. The mailing address for Brenda J Shaw is 1660 John Adams Pkwy, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brenda J Shaw |
|---|---|
| Address | 1660 John Adams Pkwy, Idaho Falls, Idaho |
| Phone Number | 2085238844 |
| Fax Number | 2085298684 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1679642037 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2009-12-15 |
Provider Mailing Address Detail
| Address | 1660 John Adams Pkwy |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834014360 |
| Phone Number | 2085238844 |
| Fax Number | 2085298684 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA587 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 807324700 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Brenda J Shaw by the Centers for Medicare & Medicaid Services?
The Brenda J Shaw has been assigned the NPI (National Provider Identifier) 1679642037 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Brenda J Shaw is physically located?
The Brenda J Shaw is physically situated at the following address: 1660 John Adams Pkwy, Idaho Falls, ID, 834014360.
What is Brenda J Shaw's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Brenda J Shaw is Physician Assistant, and the taxonomy code that categorizes this field of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1679642037 to Brenda J Shaw?
The Brenda J Shaw received its 1679642037 assignment from the Centers for Medicare & Medicaid Services on 2006-11-07.
As of what date were the details pertaining to Brenda J Shaw last refreshed?
The information related to the Brenda J Shaw, including its address, specialty, and other relevant details, was last updated on 2009-12-15.