Healthcare Provider Details
I. General information
NPI: 1467222166
Provider Name (Legal Business Name): INTEGRITY ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36453 N GANTZEL RD
SAN TAN VALLEY AZ
85140-7339
US
IV. Provider business mailing address
PO BOX 2620
IDAHO FALLS ID
83403-2620
US
V. Phone/Fax
- Phone: 480-562-5292
- Fax:
- Phone: 800-338-5378
- Fax: 208-523-8978
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JILL
SAILER
Title or Position: OWNER
Credential: CRNA
Phone: 701-471-1551