Excel Anesthesia Psc
Nurse Anesthetist, Certified Registered in Beaver Dam, KY. Organization (NPI-2).
NPI number1104828086
StatusActive
Last updated in NPPESJul 21, 2016
Details
- NPI
- 1104828086
- Entity type
- Organization (NPI-2)
- Legal business name
- Excel Anesthesia Psc
- Organization subpart
- No
- Enumeration date
- Aug 11, 2005
- Last updated
- Jul 21, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
| 207L00000X | Anesthesiology | – | – |
Practice location
1020 N Main StBeaver Dam, KY 42320-1553
Phone 270-274-0480 · Fax 270-274-0482
Mailing address
1020 N Main StBeaver Dam, KY 42320-1553
Phone 270-274-0480 · Fax 270-274-0482
Authorized official
Robert L Wright
Partner
2702740480
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