Provider Demographics
NPI:1073227815
Name:ANESTHESIA DEVELOPMENT PARTNERS LLC
Entity Type:Organization
Organization Name:ANESTHESIA DEVELOPMENT PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:775-934-6188
Mailing Address - Street 1:2100 IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2625
Mailing Address - Country:US
Mailing Address - Phone:775-235-2368
Mailing Address - Fax:908-653-9305
Practice Address - Street 1:2100 IDAHO ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2625
Practice Address - Country:US
Practice Address - Phone:775-235-2368
Practice Address - Fax:908-653-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty