| Autumn Lin Parizek, | |
|
801 Pole Line Rd W, Twin Falls, ID 83301-5810 | |
| (208) 814-2400 | |
| (208) 733-9463 |
| Full Name | Autumn Lin Parizek |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 801 Pole Line Rd W, Twin Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568149060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R44675 (North Dakota) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 75865 (Idaho) | Primary |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Autumn Lin Parizek, 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Autumn Lin Parizek, 801 Pole Line Rd W, Twin Falls, ID 83301-5810 Ph: (208) 814-2400 |
Mr. Chet Dansie, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Daniel Scott Johnson, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-734-7362 Fax: 208-814-0948 | |
Brendan Petersen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
John Brandon Cory, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Robert Kinghorn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 115 Falls Ave W, Twin Falls, ID 83301 Phone: 208-734-7362 Fax: 208-733-9463 | |
David A White, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 Fax: 208-814-7528 | |
Jason Rojas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-2400 |