Provider Demographics
NPI:1356743033
Name:AMSURG SANTA FE ANESTHESIA LLC
Entity type:Organization
Organization Name:AMSURG SANTA FE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT & CRED MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHENDORFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-263-4012
Mailing Address - Street 1:1630 HOSPITAL DR STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4772
Mailing Address - Country:US
Mailing Address - Phone:505-988-3373
Mailing Address - Fax:
Practice Address - Street 1:1A BURTON HILLS BLVD.
Practice Address - Street 2:ATTN: L&C
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6103
Practice Address - Country:US
Practice Address - Phone:615-240-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty