SearchIdaho367500000X

Brian Bullock, CRNA

NPI 1548600745 · on the registry since 2013 · sole proprietor

Practice

Address
415 6th St
Lewiston, ID 83501
Phone
(239) 896-3934
Organisation at this address
Michael Kos Md, Ps
St Joseph Snf Unit
St Joseph Hospital Llc
Valley Anesthesia, P.A.
Phoenix Radiology, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
107

Additional practice sites

  • 131 Medical Park Rd, Mooresville, NC
  • 170 N 1100 E, American Fork, UT

Registry record

Primary taxonomy
367500000X
367500000X
Also registered as
367500000X
367500000X
Licence states on file
NC, ID, UT
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-11-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho