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Individual

KAREN DONCOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1950 E CLARK ST, SUITE G, POCATELLO, ID 83201-3314
(208) 232-7760
(208) 232-1950
Mailing address
9696 W HEATHER RD, POCATELLO, ID 83204-7232
(208) 221-5153

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RNA390
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-390
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805086500
ID
Enumeration date
05/11/2006
Last updated
10/12/2011
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