Individual
JEREMY R TAYSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
190 ARROWHEAD DR, EVANSTON, WY 82930-9266
(307) 789-3636
Mailing address
444 CRANE AVE, EVANSTON, WY 82930-4916
(208) 421-4819
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
56824
WY
367500000X
Certified Registered Nurse Anesthetist
RNA-837
ID
Other
Enumeration date
07/16/2012
Last updated
08/14/2025
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