Individual
MRS. VERA PAULINE MANSFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST, SA-C, CSFA
Contact information
Practice address
2411 E RIVERSIDE DR APT H303, EAGLE, ID 83616-7552
(208) 724-2223
Mailing address
2411 E RIVERSIDE DR APT H303, EAGLE, ID 83616-7552
(208) 724-2223
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
109984
ID
246ZC0007X
Surgical Assistant
109984
ID
246ZC0007X
Surgical Assistant
Primary
—
—
246ZS0410X
Surgical Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-158
AM BOARD OF SURG ASSIST
—
01
—
109984
NBSTSA
ID
Enumeration date
12/29/2006
Last updated
01/25/2024
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