Individual
JONATHAN MYRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2121
Mailing address
205 SW 6TH ST, BLUE SPRINGS, MO 64014-3009
(816) 982-4140
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6271866
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/10/2025
Last updated
09/22/2025
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