SAMUEL HAYWARD ELLISON

COEUR D ALENE, ID
NPI1811627250
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: KS  43-557976-071)
Enumeration Date2022-06-16
Last Update Date2022-06-16
Business Address
SAMUEL HAYWARD ELLISON CRNA
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814-6051
Phone number: 509-432-4529
Mailing Address
SAMUEL HAYWARD ELLISON CRNA
1028 COMPTON CT
MOSCOW, ID 83843-8531
Phone number: 509-432-4529
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