Provider Demographics
NPI:1508047093
Name:SOUTHEAST ANESTHESIA SOLUTIONS, LLC
Entity Type:Organization
Organization Name:SOUTHEAST ANESTHESIA SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:C R N A
Authorized Official - Phone:615-776-4148
Mailing Address - Street 1:73 GOVERNORS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8926
Mailing Address - Country:US
Mailing Address - Phone:615-776-4148
Mailing Address - Fax:615-776-7337
Practice Address - Street 1:73 GOVERNORS WAY
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8926
Practice Address - Country:US
Practice Address - Phone:615-776-4148
Practice Address - Fax:615-776-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000010793367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty