Healthcare Provider Details

I. General information

NPI: 1619562006
Provider Name (Legal Business Name): DESERT SUNRISE ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 N CRAYCROFT RD BLDG 8
TUCSON AZ
85712-2845
US

IV. Provider business mailing address

1517 N WILMOT RD # 162
TUCSON AZ
85712-4410
US

V. Phone/Fax

Practice location:
  • Phone: 520-230-7156
  • Fax:
Mailing address:
  • Phone: 520-230-7156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: NEESANN MARIETTA
Title or Position: MANAGER
Credential:
Phone: 520-230-7156