Individual
DANIEL C. MCCLENAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
16 ELI LN, SALMON, ID 83467-5094
(208) 756-8027
Mailing address
16 ELI LN, SALMON, ID 83467-5094
(208) 756-8027
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
32452
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32452
STATE LICENSE NUMBER
MT
01
—
RNA-623
STATE LICENSE NUMBER
ID
Enumeration date
08/07/2006
Last updated
07/08/2007
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