Individual
EMILY VAN DYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 376-6416
Mailing address
PO BOX 7411114, CHICAGO, IL 60674-1114
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
285335
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
68436
ID
Other
Enumeration date
05/05/2021
Last updated
10/02/2023
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