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Contact Information

SHAWN A WREN, CRNA
98 POPLAR ST
BLACKFOOT, ID83221
 Phone: 208-785-4100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for SHAWN A WREN · (Male)

NPI # 1922530062
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 03/29/2017
Last updated 07/30/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • ID License # 59106
  • NM License # CRNA-01479
  • ID Medicaid 1922530062
Hospital affiliation(s)
  • BINGHAM MEMORIAL HOSPITAL - (Critical Access)
    98 POPLAR STREET
    BLACKFOOT, ID 83221
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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