Organization · NPI-2

Advanced Anesthesia Services LLC

Nurse Anesthetist, Certified Registered · Corinth, MS

NPI number1003387044
StatusActive
Last updated in NPPESJan 12, 2020

Details

NPI
1003387044
Entity type
Organization (NPI-2)
Legal business name
Advanced Anesthesia Services LLC
Organization subpart
No
Enumeration date
Dec 17, 2018
Certification date
Jan 12, 2020
Last updated
Jan 12, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered––Yes
261QS0132X Clinic/Center, Ophthalmologic Surgery––

Practice location

306 Bradley Rd
Corinth, MS 38834-7047

Phone 662-286-9292

Mailing address

106 High Forest Dr
Tupelo, MS 38801-0401

Phone 662-322-6616

Authorized official

Thomas Peter Gransinger
Crna
6623226616

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