Provider Demographics
NPI:1568658565
Name:SIGNATURE ANESTHESIA LLC
Entity Type:Organization
Organization Name:SIGNATURE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGBY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:239-278-9955
Mailing Address - Street 1:6241 ARC WAY
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1352
Mailing Address - Country:US
Mailing Address - Phone:239-278-9955
Mailing Address - Fax:239-278-9966
Practice Address - Street 1:6241 ARC WAY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1352
Practice Address - Country:US
Practice Address - Phone:239-278-9955
Practice Address - Fax:239-278-9966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty