Individual
SHARM R STANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
111 W STATE ST, BOISE, ID 83702-0001
(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
Primary
256594
AZ
367500000X
Certified Registered Nurse Anesthetist
R1664474
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
389105000
—
MN
01
—
P00617237
MEDICARE, RAILROAD
MN
Enumeration date
04/24/2007
Last updated
04/27/2021
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