Provider Demographics
NPI:1568737583
Name:PINTLER PEAKS ANESTHESIA, LLC
Entity Type:Organization
Organization Name:PINTLER PEAKS ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:TANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:406-563-0675
Mailing Address - Street 1:2111 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1719
Mailing Address - Country:US
Mailing Address - Phone:406-563-0675
Mailing Address - Fax:
Practice Address - Street 1:2111 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-1719
Practice Address - Country:US
Practice Address - Phone:406-563-0675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT25506367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty