Provider Demographics
NPI:1073718979
Name:TRIPLE CROWN ANESTHESIA PLLC
Entity Type:Organization
Organization Name:TRIPLE CROWN ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:502-718-3437
Mailing Address - Street 1:444 S 1ST ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1416
Mailing Address - Country:US
Mailing Address - Phone:502-238-2888
Mailing Address - Fax:
Practice Address - Street 1:444 S 1ST ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1416
Practice Address - Country:US
Practice Address - Phone:502-238-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2590A174400000X
367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty