Individual
RAND N. BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 882-4511
Mailing address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 882-4511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
CRNA000310
NV
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-959A
ID
Other
Enumeration date
02/03/2006
Last updated
04/23/2019
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