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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619375110 NPPES
Idaho Other CNM-80A ADVANCED PRACTICE LICENSE

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