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General NPI Number Information
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NPI Number | 1164383865
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Entity Type | Individual
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Provider Name | SHAWNA LAFOLLETTE
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Gender | Female
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 1210 NW 16TH ST
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City | FRUITLAND
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State | ID
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Zip | 83619-2202
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Country | US
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Telephone | 208-453-9850
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Fax |
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Provider Business Mailing Address
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Address Line | 2632 N WASHINGTON AVE
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City | EMMETT
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State | ID
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Zip | 83617-9556
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Country | US
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Telephone | 208-412-5443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 31847
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License Number State | ID
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