NPI 1316570757

Mark Alan Pendleton

Practitioner Certified Registered Nurse Anesthetist Pocatello, ID

Practice location

Address: 777 Hospital Way, Pocatello, ID 83201-5175
Phone: (082) 391-0562
Fax: (208) 239-3626
Mailing address: PO Box 558, Rigby, ID 83442-0558

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 130808 (ID)

Other Nurse Anesthetist, Certified Registered providers in Idaho →

Registry record

NPI: 1316570757
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Feb 2020
Record last updated: 19 May 2020

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.