Provider Demographics
NPI:1720248578
Name:SLEEPYTIME,LLC
Entity Type:Organization
Organization Name:SLEEPYTIME,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-640-0516
Mailing Address - Street 1:1179 REDWOOD TREE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6919
Mailing Address - Country:US
Mailing Address - Phone:928-640-0516
Mailing Address - Fax:435-674-2482
Practice Address - Street 1:754 S MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-5504
Practice Address - Country:US
Practice Address - Phone:435-628-2671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT212569-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTDN6501OtherRAILROAD MEDICARE PART B
UT000064139Medicare PIN