Organization
DANIEL ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU SUMMERS DANIEL CRNA (PRESIDENT)
(208) 604-7084
Entity
Organization
Contact information
Practice address
285 VISTA DR, POCATELLO, ID 83201-4987
(208) 478-1704
Mailing address
PO BOX 3363, IDAHO FALLS, ID 83403-3363
(208) 525-2090
(208) 523-8978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-936A
ID
Other
Enumeration date
04/04/2018
Last updated
04/10/2018
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