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NPI 1275093999

NPI 1275093999 : DELANIE URRUTIA : COEUR D ALENE, ID

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General NPI Number Information
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    NPI Number           |    1275093999
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    Entity Type          |    Individual 
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    Provider Name        |    DELANIE URRUTIA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2019
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    Last Update Date     |    11/18/2021
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Provider Practice Location Address
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    Address Line         |    2003 KOOTENAI HEALTH WAY 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83814-6051
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    Country              |    US
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    Telephone            |    208-765-8585
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    101 W 8TH AVE 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99204-2307
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    Country              |    US
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    Telephone            |    509-474-3181
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    AP61158265
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    57642
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    License Number State |    ID
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