Individual
MR. LOREN KEN ZEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
25 JACOBS GULCH, KELLOGG, ID 83837
(208) 784-1221
(208) 786-1019
Mailing address
25 JACOBS GULCH, KELLOGG, ID 83837
(208) 784-1221
(208) 786-7019
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
RNA68
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
N-10526
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8040130300
—
ID
01
—
N-10526
IDAHO LICENSE
ID
Enumeration date
06/14/2006
Last updated
06/14/2011
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