CODY LAMAR OLIVERSON CRNA
Individual Provider (NPI-1)
Active
Nurse Anesthetist, Certified Registered
Provider Information
- NPI Number
1932753878- Provider Type
- Individual Provider (NPI-1)
- Credentials
- CRNA
- Status
- Active
Contact & Location
- Address
- 3100 CHANNING WAY, IDAHO FALLS, ID, 834047533
- Phone
- (208) 529-6111
Specialties & Taxonomies
Registered Nurse, Critical Care Medicine
License: ID #48308
Nurse Anesthetist, Certified Registered
Primary License: ID #62583