SHANDRA DEE AVERETT (NPI# 1720580848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720580848 |
| Entity Type | Individual |
| Full Name | SHANDRA DEE AVERETT |
| Credential | FNP-C |
| Practice Address |
98 Poplar St Blackfoot ID 83221-1758 |
| Mailing Address |
357 W 170 N Blackfoot ID 83221-5614 |
| Practice Telephone | 2087854100 |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
58040 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
98 POPLAR ST |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-1758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609871474 | Wade H Flowers Jr. | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2005-06-16 |
| 1629685177 | Lucus Craig Webb Christoffersen | Registered Nurse | 98 Poplar St, Blackfoot, ID 83221-1799 | 2020-09-29 |
| 1770111924 | Kywnynn Madsen | Dietitian, Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2020-03-31 |
| 1235795915 | Megan Lewis | Advanced Practice Midwife | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-05-17 |
| 1083177935 | Jason Lee Harmon | Student in an Organized Health Care Education/Training Program | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-04-08 |
| 1851870091 | Jennifer L Wistisen | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1799 | 2018-08-08 |
| 1114405396 | Ryan Blair Killpack | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-31 |
| 1023504651 | Amanda Wray | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-06 |
| 1699268276 | Zachary D Morrow | Nurse Anesthetist, Certified Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-06-08 |
| 1184115107 | Megan Nicole Broyles | Pharmacist | 98 Poplar St, Blackfoot, ID 83221 | 2018-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427415835 | Brittany Marie Czerna | Nurse Practitioner | 1791 Frontage Rd, Blackfoot, ID 83221-6324 | 2016-01-15 |
| 1174581425 | Kay M Powell | Nurse Practitioner | 9 Airport Rd, Blackfoot, ID 83221-1702 | 2006-05-03 |
| 1033674916 | Advanced Integrated Medical Center | Nurse Practitioner | 1395 Nw Main St, Blackfoot, ID 83221-3936 | 2019-02-05 |
| 1295223493 | Carolyn Louise Hansen | Nurse Practitioner | 98 Poplar St, Blackfoot, ID 83221-1799 | 2018-04-24 |
| 1720448590 | Max Barney | Nurse Practitioner | 1441 Parkway Dr, Blackfoot, ID 83221-1667 | 2016-03-07 |
| 1962895888 | Brian Robert Johnson | Nurse Practitioner | 1350 Parkway Dr, Blackfoot, ID 83221-1657 | 2015-03-17 |
| 1477984524 | Shantel Steffler | Nurse Practitioner | 1441 Parkway Dr, Blackfoot, ID 83221-1667 | 2013-11-27 |
| 1821253683 | Jonathan Keith Williams | Nurse Practitioner | 1441 Parkway Dr, Blackfoot, ID 83221-1667 | 2008-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427152 | Christopher Alan Anthony Nicholas | Nurse Practitioner | 2889 N Chancery Pl, Meridian, ID 83646-7407 | 2020-11-05 |
| 1710588108 | Lauren Proteau | Nurse Practitioner | 310 S Acer Loop, Post Falls, ID 83854-8809 | 2020-11-03 |
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1023617347 | Kristina Oliver | Nurse Practitioner | 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-2668 | 2020-10-19 |
| 1730787482 | John Dustin Pena | Nurse Practitioner | 102 Courthouse Dr Ste F, Salmon, ID 83467-3905 | 2020-10-14 |
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1659979516 | Jennifer Anne Gardner | Nurse Practitioner | 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 | 2020-10-13 |
| 1982210795 | Samuel Hally | Nurse Practitioner | 1346 Cimarron Ct, Middleton, ID 83644-5894 | 2020-09-17 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1649885534 | Auston Whitmer | Nurse Practitioner | 2203 E Ringneck St, Meridian, ID 83646-7410 | 2020-09-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.