Organization
CRC ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TAYLOR CRNA (PARTNER)
(208) 716-0022
Entity
Organization
Contact information
Practice address
3310 VALENCIA DR, IDAHO FALLS, ID 83404-7502
(208) 525-2090
(208) 523-8978
Mailing address
PO BOX 3302, IDAHO FALLS, ID 83403-3302
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/16/2018
Last updated
10/17/2018
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