| NPI | 1780124081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE L CROFT Billing Manager 208-525-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM RN-76102) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |