NPI age
20 years
Enumerated 2005-09-08
Across 575 active nurse anesthetist, certified registered providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 001667900 | |
| 01 (ID) | N24684 | IDAHO LICENSE |
| 01 (ID) | A3516 | BC ID |
| 01 | P00137199 | RAILROAD MEDICARE |
| 05 (WA) | 9640327 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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