Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grant Gundersen, CNRA

Individual provider Certified Registered Nurse Anesthetist · NPI 1467863829

Grant Gundersen, CNRA is a Certified Registered Nurse Anesthetist (CRNA) in Blackfoot, Idaho. Qualified in 2012, 14 years ago. Practices with St Alphonsus Professional Medical Services LLC, a 123-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
14
Licensed in
ID
In the registry since
2014
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Practice location Address checks out

646 W 300 S
Blackfoot, ID 83221-6334
Phone: (208) 760-7529
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence N-38994 (ID)

Record details

NPI number1467863829
Entity typeIndividual (Type 1)
GenderMale
Credentials CNRA
Sole proprietorNo
NPI enumeratedMay 19, 2014
Last updated in NPPESMay 19, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice St Alphonsus Professional Medical Services Llc — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Blackfoot