Individual
BRIGHAM DERK MURRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
222 W IOWA AVE STE B, NAMPA, ID 83686-6814
(208) 467-3432
(208) 467-4147
Mailing address
PO BOX 3208, IDAHO FALLS, ID 83403-3208
(801) 941-8794
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-833A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619234655
—
ID
Enumeration date
04/16/2012
Last updated
11/15/2017
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