TERRY BLACK

BOISE, ID
NPI1902843584
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA302)
Additional Taxonomies163W00000X Registered Nurse
(Licence: ID  N22112)
Enumeration Date2006-06-01
Last Update Date2007-11-20
Business Address
-- TERRY BLACK CRNA
1055 N CURTIS RD
BOISE, ID 83706-1352
Phone number: 208-367-6416
Mailing Address
-- TERRY BLACK CRNA
PO BOX 4008
PORTLAND, OR 97208-4008
Phone number: 503-372-2740