Individual
MARYBETH PUZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
2537 W STATE ST STE 200, BOISE, ID 83702-2200
(208) 336-0895
(208) 338-1796
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N24138
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA341
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004368600
—
ID
Enumeration date
06/08/2006
Last updated
02/05/2018
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