Provider Demographics
NPI:1629292115
Name:PARAMOUNT ANESTHESIA SERVICES PLLC
Entity Type:Organization
Organization Name:PARAMOUNT ANESTHESIA SERVICES PLLC
Other - Org Name:PREMIER CRNA RELIEF
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:270-284-9611
Mailing Address - Street 1:1917 VERSNICK WAY
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-8694
Mailing Address - Country:US
Mailing Address - Phone:270-824-9611
Mailing Address - Fax:270-821-9901
Practice Address - Street 1:444 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2871
Practice Address - Country:US
Practice Address - Phone:270-836-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4198A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty