Shawna Marie Reynolds, PA

NPI #1023260783 in Blackfoot, Idaho

Provider Information

NPI Number: 1023260783
Entity Type: Individual
Name: Shawna Marie Reynolds, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Oct 14, 2008
Last Updated: Apr 23, 2012

Practice Location

Address: 1441 PARKWAY DR
City: Blackfoot
State: Idaho
ZIP Code: 83221-0000
Phone: (208) 785-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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