Individual
JED D HANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-3830
Mailing address
PO BOX 1627, IDAHO FALLS, ID 83403-1627
(208) 552-8778
(208) 523-2025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-849A
ID
Other
Enumeration date
08/28/2012
Last updated
12/20/2012
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