Individual
MRS. V M. CUPPAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
111 W STATE ST, BOISE, ID 83702-6127
(208) 336-0281
Mailing address
16 PLACER CREEK RD, BOISE, ID 83716-4245
(208) 392-9790
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-578
ID
Other
Enumeration date
07/22/2006
Last updated
07/08/2007
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