Provider Demographics
NPI:1376182758
Name:NATIVE ANESTHESIA LLC
Entity Type:Organization
Organization Name:NATIVE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:THRUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:480-682-8121
Mailing Address - Street 1:2747 E UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-8437
Mailing Address - Country:US
Mailing Address - Phone:480-682-8121
Mailing Address - Fax:
Practice Address - Street 1:2747 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-8437
Practice Address - Country:US
Practice Address - Phone:480-682-8121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty