Individual
LARRY EDGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 455-3940
Mailing address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 455-3940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA17
ID
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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