Provider Demographics
NPI:1346744497
Name:ANESTHESIA SERVICES NETWORK
Entity Type:Organization
Organization Name:ANESTHESIA SERVICES NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NJENGA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:610-331-0240
Mailing Address - Street 1:136 WESTBURY RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5542
Mailing Address - Country:US
Mailing Address - Phone:610-331-0240
Mailing Address - Fax:
Practice Address - Street 1:7474 GREENWAY CENTER DR STE 1100
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3500
Practice Address - Country:US
Practice Address - Phone:610-331-0240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001582367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty