Provider Demographics
NPI:1013126457
Name:BROWNLEE, JOHN PIERCE JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PIERCE
Last Name:BROWNLEE
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:49 DIAMOND HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:OLDTOWN
Mailing Address - State:ID
Mailing Address - Zip Code:83822-9593
Mailing Address - Country:US
Mailing Address - Phone:208-437-2047
Mailing Address - Fax:
Practice Address - Street 1:6640 KANIKSU STREET
Practice Address - Street 2:BOUNDARY COMMUNITY HOSPITAL
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805
Practice Address - Country:US
Practice Address - Phone:208-267-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-28966163W00000X
WARN00066178163W00000X
IDRNA440367500000X
WAAP30006256367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered