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General NPI Number Information
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NPI Number | 1720783996
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Entity Type | Individual
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Provider Name | STEPHANIE ANN SHAWVER AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 704 2ND AVE N
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City | TWIN FALLS
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State | ID
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Zip | 83301-5746
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Country | US
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Telephone | 208-207-9422
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 STARLIGHT LOOP
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City | TWIN FALLS
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State | ID
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Zip | 83301-5182
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Country | US
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Telephone | 208-293-5161
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 76327
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License Number State | ID
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