Individual
BRENT MICHAEL SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2532 CORONADO, IDAHO FALLS, ID 83404
(208) 557-2700
Mailing address
PO BOX 210, ROY, UT 84067-0210
(801) 825-4700
(801) 825-9076
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C146478
ID
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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