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Individual

DANIEL JAMES PARKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
333 N 18TH AVE STE A, POCATELLO, ID 83201-3358
(208) 233-8880
Mailing address
PO BOX 4107, POCATELLO, ID 83205-4107
(208) 233-8880

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN60263810
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-908A
ID

Other

Enumeration date
06/17/2014
Last updated
03/02/2022
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