Organization
FANCY ANESTHESIA SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANCE GREEN CRNA (OWNER)
(928) 368-8118
Entity
Organization
Contact information
Practice address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7831
(928) 368-8118
(928) 368-8121
Mailing address
PO BOX 295, SNOWFLAKE, AZ 85937-0295
(928) 368-8118
(928) 368-8121
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN102790
AZ
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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