Individual
MR. SHAUN RYAN SIBBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 695-1342
Mailing address
4624 N FIELDCREST WAY, BOISE, ID 83704-1249
(208) 695-1342
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
72054
ID
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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