| NPI | 1922990035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA TEGAN Credentialing & Billing 208-734-7362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-11-06 |