Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Colleen M Shackelford, NP

Individual provider Registered Nurse · NPI 1104107317

Mrs. Colleen M Shackelford, NP is a Registered Nurse in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
Specialties on file
3
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

300 E Bannock St
Boise, ID 83712-6207
Phone: (208) 342-7400
Fax: (208) 342-1879
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP1127A (ID)
Registered Nurse Taxonomy 163W00000X · Licence N-41423 (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence NP-1127A (ID)

Record details

NPI number1104107317
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedAugust 31, 2011
Last updated in NPPESOctober 4, 2018

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