Individual
MISS JEANNE M DEBARTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
111 W STATE ST, BOISE, ID 83702-6127
(208) 336-0895
(208) 338-1796
Mailing address
111 W STATE ST, BOISE, ID 83702-6127
(208) 336-0895
(208) 338-1796
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
AP60268686
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA500
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806142300
—
ID
Enumeration date
08/11/2006
Last updated
12/07/2022
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