IndividualActive
Shelby Gibbons, PA-C
NPI 1265009781 · Surgical Physician Assistant · Boise, ID
Provider details
- NPI number
- 1265009781
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA61349330 (WA)
Practice location
2619 W Fairview Ave Ste 3100
Boise, ID 83702-6722
Phone: (208) 706-2663
Fax: (208) 486-4300
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Registry dates
- Enumerated
- 2021-06-04
- Last updated
- 2024-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.