Healthcare Provider Details

I. General information

NPI: 1639498702
Provider Name (Legal Business Name): NEVADA ANESTHESIA PROFESSIONALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 MORENO CT
LAS VEGAS NV
89129-6312
US

IV. Provider business mailing address

3524 MORENO CT
LAS VEGAS NV
89129-6312
US

V. Phone/Fax

Practice location:
  • Phone: 508-971-6194
  • Fax: 702-998-6977
Mailing address:
  • Phone: 508-971-6194
  • Fax: 702-998-6977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: NORMA F SORELLE
Title or Position: PRESIDENT
Credential: CRNA
Phone: 508-971-6194