Organization
ST. MARY'S HOSPITAL INC
Active
Organization
ST. MARY'S HOSPITAL INC
Active
Parent organization
KOOTENAI HEALTH, INC.
Other names
Anesthesia Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
KOOTENAI HEALTH, INC.
Authorized official
LENNE BONNER (CEO)
(208) 476-8008
Entity
Organization
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522
(208) 962-3251
Mailing address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3251
(208) 962-3722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
33
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010158532
BLUE SHIELD GROUP PROV #
ID
05
—
002286200
—
ID
Enumeration date
06/11/2007
Last updated
08/10/2026
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