Provider Demographics
NPI:1740914043
Name:TORTOISE ANESTHESIA LLC
Entity type:Organization
Organization Name:TORTOISE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTON
Authorized Official - Middle Name:THUNDER
Authorized Official - Last Name:GEYE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:262-607-0984
Mailing Address - Street 1:517 PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53191-3732
Mailing Address - Country:US
Mailing Address - Phone:262-607-0984
Mailing Address - Fax:
Practice Address - Street 1:6495 S 27TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8034
Practice Address - Country:US
Practice Address - Phone:414-574-0253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty