Organization
MACIESKI CRNA PC
Active
Organization
MACIESKI CRNA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS C MACIESKI CRNA (PRESIDENT)
(208) 523-5172
Entity
Organization
Contact information
Practice address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2700
Mailing address
PO BOX 3530, IDAHO FALLS, ID 83403-3530
(208) 523-4906
(208) 523-2025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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