Individual
MICHAEL ROBERT ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2537 W STATE ST, BOISE, ID 83702-2200
(208) 336-0895
Mailing address
4172 S SELATIR WAY, MERIDIAN, ID 83642-8489
(208) 921-4113
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
44136
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
75374
ID
Other
Enumeration date
10/11/2022
Last updated
08/12/2025
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