Fontaine, Shaundra Renee
Fontaine, Shaundra Renee is an individual health care provider with primary practice located at 207 W Washington St , Boise ID 83702-5989. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Fontaine, Shaundra Renee can be contacted via phone (208) 343-2079.Contact Information
Primary practice address
207 W Washington St
Boise ID 83702-5989
Phone: (208) 343-2079
Fax: (208) 343-6828
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | A-80 | Idaho |
Profile Details
NPI number | 1619375110 |
---|---|
LBN Legal business name | Fontaine, Shaundra Renee |
Credentials | RN, APRN, CNM |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 15th, 2014 |
Last updated | Mar 30th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619375110 | NPPES |
Idaho | Other | CNM-80A | ADVANCED PRACTICE LICENSE |
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