Provider Demographics
| NPI: | 1659062867 |
|---|---|
| Name: | WEST ANESTHESIA STAFFING LLC |
| Entity type: | Organization |
| Organization Name: | WEST ANESTHESIA STAFFING LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRACTICE ADMINISTRATOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | POPPY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | WALKER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MBA |
| Authorized Official - Phone: | 325-660-5535 |
| Mailing Address - Street 1: | 3301 S 14TH ST STE 16180 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ABILENE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 79605-5015 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 325-660-5535 |
| Mailing Address - Fax: | 325-692-6030 |
| Practice Address - Street 1: | 1949 FLORENCE BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | FLORENCE |
| Practice Address - State: | AL |
| Practice Address - Zip Code: | 35630-2729 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 256-415-8100 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-05-18 |
| Last Update Date: | 2023-05-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Single Specialty |