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General NPI Number Information
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NPI Number | 1144070673
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Entity Type | Organization
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Legal Business Name | BLUE SKIES ANESTHESIA LLC
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 624 S 1000 E STE 105
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City | ST GEORGE
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State | UT
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Zip | 84790-5902
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Country | US
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Telephone | 801-876-0033
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Fax |
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Provider Business Mailing Address
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Address Line | 6397 STONE RIDGE DR
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City | MORGAN
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State | UT
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Zip | 84050-6811
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Country | US
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Telephone | 801-876-0033
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BRIDGET R TESCH
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Credential |
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Telephone | 801-876-0033
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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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