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NPI Code Detail

MEDICARE: DENALI ANESTHESIA, LLC

MEDICARE: DENALI ANESTHESIA, LLC
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
1367500000XCertified Registered Nurse Anesthetist
2207L00000XAnesthesiology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1508854712
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENALI ANESTHESIA, LLC
Provider Business Mailing Address
First Line : 14700 28TH AVE N STE 20
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-4876
Country : US
Telephone Number : 763-559-3779
Fax Number : 763-450-3986
Provider Business Practice Location Address
First Line : 2801 DEBARR RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2932
Country : US
Telephone Number : 907-258-2149
Fax Number : 907-258-2147
Authorized Official
Title or Position : PRESIDENT
Name : JOHN MORRIS
Credential : MD
Telephone Number : 304-276-3170
Provider Enumeration Date : 10/11/2005
Last Update Date : 03/21/2023

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Directions to “DENALI ANESTHESIA, LLC ” Practice Location

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