Individual
BETH NASER DITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA115
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004378500
—
ID
Enumeration date
03/21/2007
Last updated
05/21/2014
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