Provider Demographics
NPI:1932306883
Name:INDEPENDENT ANESTHESIA SERVICES, LLC
Entity Type:Organization
Organization Name:INDEPENDENT ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LOU ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:785-966-3138
Mailing Address - Street 1:14395 HWY 75
Mailing Address - Street 2:
Mailing Address - City:MAYETTA
Mailing Address - State:KS
Mailing Address - Zip Code:66509
Mailing Address - Country:US
Mailing Address - Phone:785-966-3138
Mailing Address - Fax:785-966-3138
Practice Address - Street 1:14395 HWY 75
Practice Address - Street 2:
Practice Address - City:MAYETTA
Practice Address - State:KS
Practice Address - Zip Code:66509
Practice Address - Country:US
Practice Address - Phone:785-966-3138
Practice Address - Fax:785-966-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54661367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty