Healthcare Provider Details

I. General information

NPI: 1306892807
Provider Name (Legal Business Name): LESLIEANN SCHWEIGER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N CURTIS RD
BOISE ID
83706-1352
US

IV. Provider business mailing address

PO BOX 4268
PORTLAND OR
97208-4268
US

V. Phone/Fax

Practice location:
  • Phone: 208-367-6416
  • Fax:
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN28781
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA436A
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: