NPI age
20 years
Enumerated 2005-08-19
Across 575 active nurse anesthetist, certified registered providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | 3521 | CALIFORNIA BOARD OF REGISTERED NURSING |
| 01 (ID) | 640A | IDAHO BOARD OF NURSING |
| 05 (MN) | 130148900 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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