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General NPI Number Information
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NPI Number | 1659501286
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Entity Type | Organization
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Legal Business Name | LESLIEANN SCHWEIGER CRNA CHARTERED
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 1601 E 17TH ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-6313
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Country | US
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Telephone | 208-525-2090
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Fax | 208-525-2662
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Provider Business Mailing Address
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Address Line | 9369 W PANDION CT
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City | BOISE
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State | ID
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Zip | 83714-6715
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Country | US
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Telephone | 208-854-1703
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LESLIEANN SCHWEIGER
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Credential | CRNA
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Telephone | 208-854-1703
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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 | N28781
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License Number State | ID
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