Innovative Anesthesia
Organization Active NPI Certified Registered Nurse Anesthetist · Ponderay, ID
NPI 1902036734 · NPPES record last updated Jul 14, 2009
Key facts
- NPI
- 1902036734
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RNA-491A (ID)
- Legal business name
- INNOVATIVE ANESTHESIA
- Practice address
- 30544 Highway 200 Ste 201
Pend Oreille Surgery Center
Ponderay, ID 83852-5005 - Phone
- (208) 265-8194
- NPI assigned
- Jul 14, 2009
- Organization subpart
- No
Authorized official
- Name
- Bruce Demko
- Title
- Partner
- Phone
- (208) 265-3534
Practitioners 1
-
Bruce William Demko, CRNA
National Provider Directory
Locations
30544 Highway 200
Ste 201
Ponderay, ID 83852
Phone (208) 265-8194
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist |
367500000X | RNA-491A | ID | Yes |
Addresses
Primary practice location
30544 Highway 200 Ste 201
Pend Oreille Surgery Center
Ponderay, ID 83852-5005
Mailing address
PO Box 591
Sagle, ID 83860-0591
Other providers in Ponderay, ID
- Tara Heisey
- Jessica Hunt
- Idaho Dept of Health & Welfare Reg 1 Ahm PSR Sandpoint
- Idaho Dept of Health & Welfare Reg 1 Amh Clinic Sandpoint
- Inland Northwest Renal Care Group, LLC
- Inspire Change Therapeutic Services PLLC
- Daniel Grant Freeman Jefferies
- Brenda Kay Jerald
- Jesstherapy PLLC
- Kauai in-Home Therapy LLC
All providers in Ponderay, ID · Certified Registered Nurse Anesthetist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.