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General NPI Number Information
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NPI Number | 1326864877
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Entity Type | Organization
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Legal Business Name | AYA ANESTHESIA, LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 11606 NICHOLAS ST
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City | OMAHA
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State | NE
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Zip | 68154-4478
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Country | US
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Telephone | 402-493-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 10513 ROSEWATER PKWY
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City | BENNINGTON
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State | NE
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Zip | 68007-8104
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Country | US
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Telephone | 402-278-2536
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VALERIE SHAW
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Credential | CRNA
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Telephone | 402-278-2536
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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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