NPI age
20 years
Enumerated 2005-08-29
Across 575 active nurse anesthetist, certified registered providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | A4381 | BC ID |
| 05 (ID) | 807070200 | |
| 05 (WA) | 9642851 | |
| 01 | P00372632 | RAILROAD MEDICARE |
| 01 (ID) | N434380 | IDAHO LICENSE |
Part of a multi-provider practice. 58 other active providers share this practice address in NPPES.
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