NPI 1225597305

Lyle Jeremy Jackson, CRNA

Practitioner Orthopedic Registered Nurse Idaho Falls, ID

Practice location

Address: 2325 Coronado St, Idaho Falls, ID 83404-7407
Phone: (208) 557-2700
Mailing address: 1090 Barney Dairy Rd, Rexburg, ID 83440-3542

Registered specialties (3)

Orthopedic Registered Nurse Primary

Nursing Service Providers Taxonomy 163WX0800X Licence 62439 (ID)

Other Registered Nurse providers in Idaho →

Certified Registered Nurse Anesthetist

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 125895 (VA)

Other Nurse Anesthetist, Certified Registered providers in Idaho →

Certified Registered Nurse Anesthetist

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence D183481 (IA)

Registry record

NPI: 1225597305
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Mar 2019
Record last updated: 30 Jun 2025

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.