# TRAVERSE ANESTHESIA ASSOCIATES, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013966506
- **Authorized official:** MS. NIKKI KILLIAN (BUSINESS OFFICE COORDINATOR)
- **Authorized official phone:** (231) 935-5770

## Contact information

- **Practice address:** 1105 6TH ST, MUNSON MEDICAL CENTER/TRAVERSE ANESTHESIA ASSOCIATES, P, TRAVERSE CITY, MI 49684-2349
- **Practice address phone:** (231) 935-5770
- **Practice address fax:** (231) 935-0747
- **Mailing address:** 4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684-7331
- **Mailing address phone:** (231) 935-5770
- **Mailing address fax:** (231) 935-0747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 11/02/2007