Individual
ALBERT WILLIAM MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-5777
(208) 476-5385
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
RNA457
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA457A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805843500
—
ID
Enumeration date
03/21/2007
Last updated
12/30/2020
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