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General NPI Number Information
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NPI Number | 1306660725
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Entity Type | Organization
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Legal Business Name | NOLA GIRL NURSING ANESTHESIA CORPORATION
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 5400 BALBOA BLVD STE 111
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City | ENCINO
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State | CA
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Zip | 91316-5206
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Country | US
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Telephone | 833-540-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 NEILSON WAY APT 221
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City | SANTA MONICA
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State | CA
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Zip | 90405-4012
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Country | US
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Telephone | 504-416-0717
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TANYA FRANZ SMITH
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Credential | CRNA
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Telephone | 504-416-0717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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