Individual
THAD HOLLIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
115 FALLS AVE W, TWIN FALLS, ID 83301
(208) 733-1662
(208) 733-9463
Mailing address
115 FALLS AVE W, TWIN FALLS, ID 83301-3115
(208) 734-3356
(208) 733-9463
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01423
NM
Other
Enumeration date
07/08/2016
Last updated
01/11/2023
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