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General NPI Number Information
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NPI Number | 1174468011
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Entity Type | Organization
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Legal Business Name | IDAHO ANESTHESIA PARTNERS LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 875 S VANGUARD WAY STE 300
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City | MERIDIAN
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State | ID
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Zip | 83642-8613
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Country | US
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Telephone | 208-488-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 2960 EAST ST. LUKE'S STREET STE 400
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-488-0066
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TIMOTHY POWELL
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Credential | CRNA
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Telephone | 360-489-5766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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