Organization
HAYDEN LAKE ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE THOMAS SHIBLEY CRNA (MANAGING PARTNER)
(208) 209-6804
Entity
Organization
Contact information
Practice address
8552 N GOVERNMENT WAY, HAYDEN, ID 83835-9280
(208) 660-3604
Mailing address
PO BOX 295, HAYDEN, ID 83835-0295
(208) 209-6804
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/04/2026
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