Individual
THOMAS LAMAR MOURITSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 E HASKELL ST, WINNEMUCCA, NV 89445-3247
(775) 623-5222
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
202100196CRNA
ID
367500000X
Certified Registered Nurse Anesthetist
826747
NV
Other
Enumeration date
01/15/2020
Last updated
09/18/2025
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