Provider Demographics
NPI:1750505707
Name:NURSE ANESTHETIST SERVICES, INC
Entity Type:Organization
Organization Name:NURSE ANESTHETIST SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COBY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-836-0190
Mailing Address - Street 1:1040 TOWNE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5787
Mailing Address - Country:US
Mailing Address - Phone:724-836-0190
Mailing Address - Fax:724-837-4350
Practice Address - Street 1:516 PELLIS RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4592
Practice Address - Country:US
Practice Address - Phone:724-836-1177
Practice Address - Fax:724-836-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100754110Medicaid
PAP033978OtherCHAMPUS
PA615438OtherHIGHMARK GROUP NUMBER
PAP033978OtherCHAMPUS