TAMMY L SKIDMORE

POCATELLO, ID
NPI1427008176
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA-582)
Additional Taxonomies163W00000X Registered Nurse
(Licence: ID  N27623)
Enumeration Date2006-05-12
Last Update Date2011-11-01
Business Address
-- TAMMY L SKIDMORE CRNA
777 HOSPITAL WAY
POCATELLO, ID 83201-5175
Phone number: 208-239-1000
Mailing Address
-- TAMMY L SKIDMORE CRNA
PO BOX 4107
POCATELLO, ID 83205-4107
Phone number: 208-232-7760