Provider Demographics
NPI:1205905767
Name:NORTH CENTRAL ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:NORTH CENTRAL ANESTHESIA SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA/ MHS
Authorized Official - Phone:402-340-1117
Mailing Address - Street 1:514 DEER RUN LN
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4331
Mailing Address - Country:US
Mailing Address - Phone:402-340-1117
Mailing Address - Fax:888-482-8874
Practice Address - Street 1:514 DEER RUN LN
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4331
Practice Address - Country:US
Practice Address - Phone:402-340-1117
Practice Address - Fax:888-482-8874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-12-12
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
NE08551OtherBCBSNE AVERA ST ANTHONY'S
NE08551OtherBCBSNE AVERA ST ANTHONY'S