Provider Demographics
NPI:1699225631
Name:SLEEPERS ANESTHESIA SERVICES, PLLC
Entity Type:Organization
Organization Name:SLEEPERS ANESTHESIA SERVICES, PLLC
Other - Org Name:ERIC SHAWN GOSSER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:GOSSER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:606-669-2728
Mailing Address - Street 1:60 WATERFALL LN
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-8521
Mailing Address - Country:US
Mailing Address - Phone:606-669-2728
Mailing Address - Fax:
Practice Address - Street 1:236 W MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1876
Practice Address - Country:US
Practice Address - Phone:859-239-9680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005145367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100003870Medicaid