Individual
BENJAMIN GUERCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1224 8TH ST, RUPERT, ID 83350-1527
(208) 436-0481
Mailing address
98 RIVERSIDE DR, BURLEY, ID 83318-5415
(801) 300-8071
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
51561064406
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
N-44886
ID
Other
Enumeration date
06/10/2008
Last updated
01/30/2017
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