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Individual

TYLER WILLIAM HORGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
223425
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
72208
ID

Other

Enumeration date
08/02/2020
Last updated
10/20/2023
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