Individual
DAVID NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
100 HOSPITAL DR, KETCHUM, ID 83340
(208) 727-8800
(208) 727-8124
Mailing address
7154 W STATE ST STE 119, BOISE, ID 83714-7421
(505) 280-0657
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
59928
ID
367500000X
Certified Registered Nurse Anesthetist
CRNA00752
NM
367500000X
Certified Registered Nurse Anesthetist
NA95000124
CA
367500000X
Certified Registered Nurse Anesthetist
R48739
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18100244
—
NM
Enumeration date
01/03/2006
Last updated
03/15/2026
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