Provider Demographics
NPI:1134630320
Name:HIGHLINE ANESTHESIA LLC
Entity type:Organization
Organization Name:HIGHLINE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:REED
Authorized Official - Last Name:TORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-644-8473
Mailing Address - Street 1:1225 OLD OREGON RD
Mailing Address - Street 2:
Mailing Address - City:SODA SPRINGS
Mailing Address - State:ID
Mailing Address - Zip Code:83276-5608
Mailing Address - Country:US
Mailing Address - Phone:801-644-8473
Mailing Address - Fax:
Practice Address - Street 1:1225 OLD OREGON RD
Practice Address - Street 2:
Practice Address - City:SODA SPRINGS
Practice Address - State:ID
Practice Address - Zip Code:83276-5608
Practice Address - Country:US
Practice Address - Phone:801-644-8473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA-721A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty