Healthcare Provider Details

I. General information

NPI: 1720248578
Provider Name (Legal Business Name): SLEEPYTIME,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 S MAIN ST SUITE 3
ST GEORGE UT
84770-5504
US

IV. Provider business mailing address

1179 REDWOOD TREE ST
SAINT GEORGE UT
84790-6919
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-2671
  • Fax:
Mailing address:
  • Phone: 928-640-0516
  • Fax: 435-674-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number212569-4406
License Number StateUT

VIII. Authorized Official

Name: ELIZABETH J DORSEY
Title or Position: NURSE ANESTHETIST
Credential:
Phone: 928-640-0516