Samuel Bergener CRNA

NPI 1780724419 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1780724419
Gender Male
Enumeration Date 02/08/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3100 CHANNING WAY
IDAHO FALLS ID, 83404-7533, US
Phone (208) 529-6269
Fax
Business Location
255 W MICHIGAN AVE
P. O. BOX 1123
JACKSON MI, 49201-2218, US
Phone (517) 787-6440
Fax (517) 787-4146
Toxanomy
Taxonomy Code 367500000X
License State Idaho
License Number N-26821
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According to our database, Samuel Bergener CRNA NPI is 1780724419, taxonomy code is 367500000X and license number is N-26821, license state is located at Idaho. Samuel Bergener CRNA physically located at 3100 Channing Way, Idaho Falls ID, 83404-7533. NPI Number Samuel Bergener CRNA has the Individual type.

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1780724419 NPI number is provided on an as is basis without warranty of any kind. 1780724419 is maintained by the National Plan & Provider Enumeration System. The contents of Samuel Bergener CRNA are for informational purposes only.