Provider Demographics
NPI:1629752936
Name:PINEAL ANESTHESIA, PC
Entity Type:Organization
Organization Name:PINEAL ANESTHESIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CRNA
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:VANA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, CRNA, APNP
Authorized Official - Phone:319-331-2441
Mailing Address - Street 1:4815 ALGONQUIN DR APT 3
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-7998
Mailing Address - Country:US
Mailing Address - Phone:319-331-2441
Mailing Address - Fax:
Practice Address - Street 1:4815 ALGONQUIN DR APT 3
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-7998
Practice Address - Country:US
Practice Address - Phone:319-331-2441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty