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Jon F Champlin, CRNA

Nurse Anesthetist, Certified Registered in Idaho Falls, ID. Individual provider (NPI-1).

NPI number1386722429
StatusActive
Last updated in NPPESDec 21, 2007

Details

NPI
1386722429
Entity type
Individual (NPI-1)
Name
Jon F Champlin
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
Nov 2, 2006
Last updated
Dec 21, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified RegisteredRNA328AIDYes

Practice location

1945 E 17th St
Idaho Falls, ID 83404-6429

Phone 208-529-1945

Mailing address

Po Box 52180
Idaho Falls, ID 83405-2180

Phone 208-523-4906 · Fax 208-523-2025

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