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Individual

EVAN R BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 336-0895
Mailing address
1713 W JEFFERSON ST APT 301, BOISE, ID 83702-3909
(607) 237-2346

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
441268
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
77344
ID
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/27/2023
Last updated
01/18/2024
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