Provider Demographics
NPI:1982998480
Name:STEPHEN D PANTER CRNA LTD
Entity Type:Organization
Organization Name:STEPHEN D PANTER CRNA LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PANTER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:775-883-2202
Mailing Address - Street 1:313 W ANN ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3903
Mailing Address - Country:US
Mailing Address - Phone:775-883-2202
Mailing Address - Fax:775-883-0797
Practice Address - Street 1:313 W ANN ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3903
Practice Address - Country:US
Practice Address - Phone:775-883-2202
Practice Address - Fax:775-883-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV002367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty