FORREST READ PETERSON
Individual Provider (NPI-1)
Active
Nurse Anesthetist, Certified Registered
Provider Information
- NPI Number
1528531795- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 190 E BANNOCK ST, BOISE, ID, 837126241
- Phone
- (208) 381-2222
Specialties & Taxonomies
Registered Nurse
License: ID #40402
Nurse Anesthetist, Certified Registered
Primary License: ID #60550