Individual
MR. JAMES WHITMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1501 HILAND AVE, BURLEY, ID 83318-2682
(208) 525-2090
Mailing address
PO BOX 1374, IDAHO FALLS, ID 83403-1374
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-18699
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001795
—
ID
Enumeration date
11/09/2006
Last updated
11/07/2013
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