Healthcare Provider Details

I. General information

NPI: 1043672850
Provider Name (Legal Business Name): SNARR ANESTHESIA SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 HILAND AVE
BURLEY ID
83318-2688
US

IV. Provider business mailing address

PO BOX 3327
IDAHO FALLS ID
83403-3327
US

V. Phone/Fax

Practice location:
  • Phone: 208-677-8888
  • Fax: 208-523-8978
Mailing address:
  • Phone: 208-525-2090
  • Fax: 208-523-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateID

VIII. Authorized Official

Name: MICHELLE DAWN PAYNE
Title or Position: OWNER/MANAGER
Credential:
Phone: 208-525-2090