Individual
MR. BEAU S. DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
285 VISTA DR, POCATELLO, ID 83201-4987
(208) 478-1704
(770) 701-6673
Mailing address
PO BOX 3750, SALT LAKE CITY, UT 84110-3750
(800) 880-3566
(770) 701-6676
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
232645
AR
367500000X
Certified Registered Nurse Anesthetist
RNA-936A
ID
Other
Enumeration date
01/05/2010
Last updated
10/15/2025
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