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General NPI Number Information
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NPI Number | 1114272325
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Entity Type | Organization
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Legal Business Name | SANDERS NURSE ANESTHESIA SERVICES, INC
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 9308 S TOLEDO AVE
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City | TULSA
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State | OK
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Zip | 74137-2739
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Country | US
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Telephone | 918-728-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 E 570 RD
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City | CATOOSA
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State | OK
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Zip | 74015-6294
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Country | US
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Telephone | 918-344-0807
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAVONNA KAY SANDERS
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Credential | CRNA
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Telephone | 918-344-0807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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