Individual
EILEEN SHERRY BOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
670 E COUNTRYSIDE LN, IDAHO FALLS, ID 83404-7600
(208) 524-3417
Mailing address
670 E COUNTRYSIDE LN, IDAHO FALLS, ID 83404-7600
(208) 524-3417
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN12311
ID
367500000X
Certified Registered Nurse Anesthetist
APN28173153A
IN
367500000X
Certified Registered Nurse Anesthetist
APN88641
OK
Other
Enumeration date
06/08/2006
Last updated
09/01/2010
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