NPI 1043569056

Brendan Petersen, CRNA

Practitioner Certified Registered Nurse Anesthetist Twin Falls, ID

Practice location

Address: 801 Pole Line Rd W, Twin Falls, ID 83301-5810
Phone: (208) 814-1000
Mailing address: 2405 Independence St, Twin Falls, ID 83301

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence RNA-844A (ID)

Other Nurse Anesthetist, Certified Registered providers in Idaho →

Registry record

NPI: 1043569056
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Sep 2012
Record last updated: 20 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.