Julie M Acarregui, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Mountain Home, ID

NPI 1992819361 · NPPES record last updated Sep 24, 2015

Key facts

NPI
1992819361
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
RNA-432-A (ID)
Practice address
3510 NE June Lane
Mountain Home, ID 83647-5307
Phone
(208) 794-0169
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
RNA-432-AIDMDCertified Registered Nurse Anesthetist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA-432-A ID Yes

Addresses

Primary practice location

3510 NE June Lane
Mountain Home, ID 83647-5307

Mailing address

3510 NE June Lane
Mountain Home, ID 83647
Phone (208) 587-4833

Other identifiers

IdentifierTypeStateIssuer
805937500MedicaidID

Other providers in Mountain Home, ID

All providers in Mountain Home, ID · Certified Registered Nurse Anesthetist in Idaho

Sources for this page

Verify at the official NPI Registry.