NPI age
19 years
Enumerated 2006-09-06
Across 575 active nurse anesthetist, certified registered providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 050889 | CRNA LICENSE |
| 01 (TX) | 89607U | BCBS |
| 05 (TX) | 002958903 | |
| 05 (ID) | 1457939380 | |
| 01 (TX) | 625990 | TEXAS STATE NURSE LICENSE |
| 01 (TX) | P00719258 | RAILROAD |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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