Individual
TAYLOR KELLER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
120 EAST HOWARD AVENUE, TETON VALLEY HEALTH CARE, DRIGGS, ID 83422-5112
(208) 354-6302
(208) 354-3158
Mailing address
120 EAST HOWARD AVENUE, TETON VALLEY HEALTH CARE, DRIGGS, ID 83422-5112
(208) 354-6302
(208) 354-3158
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA746
ID
Other
Enumeration date
02/12/2009
Last updated
11/04/2016
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