Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRENNA MAE SHACKELFORD, MD
ActiveDR. BRENNA MAE SHACKELFORD, MD is a Hospice and Palliative Medicine (EM) healthcare provider located in MERIDIAN, Idaho. NPI 1033377833 is currently active in the NPPES registry. Verify at CMS.
Hospice and Palliative Medicine (EM) · MERIDIAN, ID
Registration Details
- NPI Number
- 1033377833
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 28, 2008 (18.245387786432 yrs)
- Last Updated
- Aug 6, 2024
- Licenses
-
MD19340 (HI)01067626A (IN)23824 (NV)A133488 (CA)M15461 (ID)
Practice Information
- Address
-
520 S EAGLE RD STE 3102MERIDIAN, ID, 836426352Browse ID providers · Browse ZIP 83642
- Phone
- 2083811615
- Fax
- 2083815141
- Primary Specialty
-
Hospice and Palliative Medicine (EM)
207PH0002X
- Additional Specialty
- Emergency Medicine
- Additional Specialty
- Emergency Medicine
- Additional Specialty
- Emergency Medicine
- Additional Specialty
- Emergency Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.