Provider Demographics
NPI:1396594198
Name:IKARE ANESTHESIA LLC
Entity type:Organization
Organization Name:IKARE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-228-3359
Mailing Address - Street 1:310 8TH AVE NW STE 508
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-2365
Mailing Address - Country:US
Mailing Address - Phone:605-262-0404
Mailing Address - Fax:605-229-7460
Practice Address - Street 1:905 N 3RD ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-2322
Practice Address - Country:US
Practice Address - Phone:605-262-0404
Practice Address - Fax:605-229-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty