Provider Demographics
NPI:1700482700
Name:L AND K ANESTHESIA SOLUTIONS
Entity Type:Organization
Organization Name:L AND K ANESTHESIA SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DNAP, CRNA
Authorized Official - Phone:314-805-0005
Mailing Address - Street 1:15 HEATHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-3116
Mailing Address - Country:US
Mailing Address - Phone:314-805-0005
Mailing Address - Fax:
Practice Address - Street 1:3801 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-2853
Practice Address - Country:US
Practice Address - Phone:414-949-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2021-03-19
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
WI10401-33OtherCRNA- APNP