Provider Demographics
NPI:1265090344
Name:SLEEPY PLAINS ANESTHESIA LLC
Entity type:Organization
Organization Name:SLEEPY PLAINS ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDGREN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:801-633-4702
Mailing Address - Street 1:PO BOX 5518
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88102-5518
Mailing Address - Country:US
Mailing Address - Phone:801-633-4702
Mailing Address - Fax:
Practice Address - Street 1:939 CURRAN DR
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-9507
Practice Address - Country:US
Practice Address - Phone:208-390-3760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty