Individual
LAUREN A MUSHENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
6140 CURTISIAN AVE, STE 400, BOISE, ID 83704-8880
(208) 367-3500
(208) 367-2968
Mailing address
6140 CURTISIAN AVE, STE 400, BOISE, ID 83704-8880
(208) 367-3500
(208) 367-2968
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
081490
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010156502
REGENCE BLUE SHIELD OF ID
ID
01
—
SA053
BLUE CROSS OF ID
ID
01
—
SA054
BLUE CROSS OF ID
ID
Enumeration date
06/08/2007
Last updated
05/10/2010
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