Healthcare Provider Details

I. General information

NPI: 1235604299
Provider Name (Legal Business Name): NORTHERN NURSING ANESTHESIA SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 GREEN VALLEY RD STE F
FREEDOM CA
95019-3133
US

IV. Provider business mailing address

416B MAIN ST
SALINAS CA
93901-3306
US

V. Phone/Fax

Practice location:
  • Phone: 831-800-7887
  • Fax: 831-998-7155
Mailing address:
  • Phone: 831-800-7887
  • Fax: 831-998-7155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT D NORTHERN
Title or Position: DIRECTOR
Credential:
Phone: 831-800-7887