Provider Demographics
NPI:1760462022
Name:BUENA VISTA ANESTHESIA ASSOCIATES PLC
Entity Type:Organization
Organization Name:BUENA VISTA ANESTHESIA ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED REGISTERED NURSE ANESTHET
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BINNING
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:712-732-8147
Mailing Address - Street 1:207 STONEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588
Mailing Address - Country:US
Mailing Address - Phone:712-732-8147
Mailing Address - Fax:712-749-5114
Practice Address - Street 1:1525 W 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588
Practice Address - Country:US
Practice Address - Phone:712-732-4030
Practice Address - Fax:712-749-5114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2020-08-22
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
IA0160879Medicaid
IA40130OtherBCBS
IA0160879Medicaid