Lyle Jeremy Jackson, CRNA
NPI #1225597305 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1225597305
- Entity Type
- Individual
- Name
- Lyle Jeremy Jackson, CRNA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Registered Nurse - Orthopedic
- Credential
- CRNA
- Enumeration Date
- Mar 18, 2019
- Last Updated
- Jun 30, 2025
Practice Location
- Address
- 2325 CORONADO ST
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7407
- Phone
- (208) 557-2700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Anesthetist, Certified Registered |
| Registered Nurse - Orthopedic — Orthopedic |
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