Individual
MR. MARK ALLEN STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
(208) 367-2742
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-6416
(208) 367-2742
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-26984
ID
367500000X
Certified Registered Nurse Anesthetist
RNA-950
ID
Other
Enumeration date
03/02/2006
Last updated
10/25/2023
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