Organization
OVERTON-STIFF PROFESSIONAL ANESTHESIA SERVICE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGUERITE OVERTON CRNA (PRESIDENT)
(208) 939-3255
Entity
Organization
Contact information
Practice address
6302 TALCREST, BOISE, ID 83713-1207
(208) 939-3255
Mailing address
PO BOX 2203, IDAHO FALLS, ID 83403-2203
(208) 525-2090
(208) 523-8978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N25778
ID
Other
Enumeration date
08/25/2006
Last updated
12/13/2012
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