Individual
MR. JOSEPH CARROLL SKINNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
366 MDOS, SGOSA, 90 HOPE DRIVE, MOUNTAIN HOME AFB, ID 83648
(208) 828-7370
Mailing address
90 HOPE DRIVE, MOUNTAIN HOME AFB, ID 83648
(208) 828-7768
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA648A
ID
Other
Enumeration date
11/30/2005
Last updated
07/08/2007
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