Provider Demographics
NPI:1942858394
Name:FOREFRONT ANESTHESIA, LLC
Entity Type:Organization
Organization Name:FOREFRONT ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-551-5105
Mailing Address - Street 1:PO BOX 292122
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-2122
Mailing Address - Country:US
Mailing Address - Phone:615-620-2333
Mailing Address - Fax:615-620-2323
Practice Address - Street 1:280 WARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-1828
Practice Address - Country:US
Practice Address - Phone:615-620-2333
Practice Address - Fax:615-620-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty