Canfield, Carlene M

Canfield, Carlene M is an sole proprietor health care provider with primary practice located at 1601 E 17Th St , Idaho Falls ID 83404-6313. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Canfield, Carlene M can be contacted via phone (208) 525-2090.

Contact Information

Primary practice address
1601 E 17Th St Idaho Falls ID 83404-6313
Phone: (208) 525-2090
Fax: (208) 525-2662
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X N-15497 Idaho

Profile Details

NPI number 1104003326
LBN Legal business name Canfield, Carlene M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2008
Last updated Apr 7th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104003326 NPPES
Idaho MEDICAID 008644600
Idaho Other A0348

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