Provider Demographics
NPI:1598183923
Name:NORTHLAND ANESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:NORTHLAND ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:320-309-1161
Mailing Address - Street 1:8990 SPRINGBROOK DR NW STE 250
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5884
Mailing Address - Country:US
Mailing Address - Phone:763-398-0099
Mailing Address - Fax:763-398-0124
Practice Address - Street 1:2055 15TH ST N STE B
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1543
Practice Address - Country:US
Practice Address - Phone:320-258-6620
Practice Address - Fax:320-258-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty