P Praxis·MD
● Active Type 1 · Individual

Grant Gundersen, CNRA

Nurse Anesthetist, Certified Registered·Blackfoot, ID· NPI 1467863829 · Enumerated 2014 · 12 years on NPI
Gundersen is 1 of 20 nurse anesthetist, certified registered providers in Blackfoot and 1 of 575 in Idaho.
NPI age
12 years
Enumerated 2014-05-19
Primary specialty
Nurse Anesthetist, Certified Registered
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2014-05-19
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 575 active nurse anesthetist, certified registered providers in Idaho.

NPI age
12 years
↓ 3 yr below median (15 yr)
State licenses
1 state
18% of peers hold multiple states
Subspecialties
0
32% of peers hold subspecialties

NPI lifetime · 2014 → 2026

2014-05Enumerated in NPPES
2014 2026

Where they practice

Practice location
646 W 300 S
Blackfoot, ID 832216334
📞 2087607529
Mailing address
646 W 300 S
Blackfoot, ID 832216334
📞 2087607529

Specialties

  • Nurse Anesthetist, Certified Registered Primary
    (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
    ID license #N-38994 taxonomy 367500000X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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