Provider Demographics
NPI:1083196505
Name:THRIVE ANESTHESIA SERVICES, INCORPORATED
Entity Type:Organization
Organization Name:THRIVE ANESTHESIA SERVICES, INCORPORATED
Other - Org Name:THRIVE ANESTHESIA SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LURA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA, APRN, RN
Authorized Official - Phone:701-934-2395
Mailing Address - Street 1:2000 SCHAFER ST STE E
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1204
Mailing Address - Country:US
Mailing Address - Phone:701-934-2395
Mailing Address - Fax:701-425-0183
Practice Address - Street 1:2000 SCHAFER ST STE E
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1204
Practice Address - Country:US
Practice Address - Phone:701-934-2395
Practice Address - Fax:701-425-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR31175367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty