Organization
TRAVERSE ANESTHESIA ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NIKKI KILLIAN (BUSINESS OFFICE COORDINATOR)
(231) 935-5770
Entity
Organization
Contact information
Practice address
1105 6TH ST, MUNSON MEDICAL CENTER/TRAVERSE ANESTHESIA ASSOCIATES, P, TRAVERSE CITY, MI 49684-2349
(231) 935-5770
(231) 935-0747
Mailing address
4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684-7331
(231) 935-5770
(231) 935-0747
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/10/2006
Last updated
11/02/2007
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