Individual
JASON M THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6269
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-29107
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807871800
—
ID
Enumeration date
04/25/2007
Last updated
06/24/2010
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