Organization
IDAHO ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KINGHORN CRNA (OWNER)
(208) 525-2090
Entity
Organization
Contact information
Practice address
650 ADDISON AVE W, TWIN FALLS, ID 83301-5444
(208) 525-2090
(208) 525-2662
Mailing address
PO BOX 1545, IDAHO FALLS, ID 83403-1545
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-15840
ID
Other
Enumeration date
11/06/2006
Last updated
08/22/2020
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