Provider Demographics
NPI:1629020862
Name:SNARR, R JARED (CRNA)
Entity Type:Individual
Prefix:
First Name:R
Middle Name:JARED
Last Name:SNARR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:JARED
Other - Last Name:SNARR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:PAUL
Mailing Address - State:ID
Mailing Address - Zip Code:83347-0548
Mailing Address - Country:US
Mailing Address - Phone:208-270-1575
Mailing Address - Fax:
Practice Address - Street 1:1501 HILAND AVE
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2688
Practice Address - Country:US
Practice Address - Phone:208-525-2090
Practice Address - Fax:208-523-8978
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA-686A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA11101OtherWELLMARK BCBS
IA0730069Medicaid
IAI18396Medicare PIN