MEDICARE: SIESTA SOLUTIONS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1407323538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIESTA SOLUTIONS, PLLC

Provider Business Mailing Address
First Line	:	4475 TRINITY MILLS ROAD #703064
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75370-0010
Country	:	US
Telephone Number	:	209-416-6321
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 N HIGHLAND AVE STE 220
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75092-7383
Country	:	US
Telephone Number	:	903-345-4114
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEP
Name	:	DAN WANN
Credential	:	CRNA
Telephone Number	:	209-416-6321

Provider Enumeration Date	:	10/26/2018
Last Update Date	:	10/26/2018

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Directions to “SIESTA SOLUTIONS, PLLC ” Practice Location

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