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Individual

MR. ALAN ROBERT BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1202 E LOCUST, EMMETT, ID 83617
(208) 365-3561
Mailing address
2571 WS SLOPE RD, EMMETT, ID 83617
(208) 365-1125

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA82
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010142352
REGENCE BLUE SHIELD ID
ID
01
HBLF2
BLUE CROSS IDAHO
ID
Enumeration date
09/01/2006
Last updated
07/08/2007
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