Individual
MR. ROCKY N VULGAMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5583 N CRIMSON WAY, BOISE, ID 83703-2840
(208) 866-5026
Mailing address
5583 N CRIMSON WAY, BOISE, ID 83703-2840
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-363
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805574900
—
ID
Enumeration date
08/24/2006
Last updated
06/11/2009
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