Healthcare Provider Details

I. General information

NPI: 1225821184
Provider Name (Legal Business Name): SES ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2264 E CINEMA DR
MERIDIAN ID
83642-8249
US

IV. Provider business mailing address

PO BOX 2587
IDAHO FALLS ID
83403-2587
US

V. Phone/Fax

Practice location:
  • Phone: 208-381-0262
  • Fax: 208-429-8575
Mailing address:
  • Phone: 208-525-2090
  • Fax: 208-523-8978

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: SHERRY SWEARNGIN
Title or Position: OWNER
Credential: CRNA
Phone: 208-863-3937