Individual
JESS LUFKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 716-7215
Mailing address
1891 KINGHORN RD, POCATELLO, ID 83201-4996
(208) 821-5563
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9493739
FL
163W00000X
Registered Nurse
RN9493739
IN
163WS0200X
School Registered Nurse
RN9493739
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
69208
ID
Other
Enumeration date
08/06/2020
Last updated
02/17/2022
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