Individual
CARLENE M CANFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1601 E 17TH ST, IDAHO FALLS, ID 83404-6313
(208) 525-2090
(208) 525-2662
Mailing address
1601 E 17TH ST, IDAHO FALLS, ID 83404-6313
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-15497
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008644600
—
ID
01
—
A0348
BLUE CROSS
ID
Enumeration date
01/30/2008
Last updated
04/07/2011
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