MEDICARE: PRN ANESTHESIA L L C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306423058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRN ANESTHESIA L L C

Provider Business Mailing Address
First Line	:	PO BOX 700309
Second Line	:
City	:	KAPOLEI
State	:	HI
Zip	:	96709-0309
Country	:	US
Telephone Number	:	808-744-0517
Fax Number	:	808-693-8060

Provider Business Practice Location Address
First Line	:	590 FARRINGTON HWY UNIT 526A
Second Line	:
City	:	KAPOLEI
State	:	HI
Zip	:	96707-2034
Country	:	US
Telephone Number	:	808-744-0517
Fax Number	:	808-693-8060

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA JANE ALSBERGAS
Credential	:	CRNA,APRN
Telephone Number	:	540-841-3367

Provider Enumeration Date	:	03/28/2021
Last Update Date	:	02/23/2024

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Directions to “PRN ANESTHESIA L L C ” Practice Location

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