Organization
GREENSBORO ANESTHESIA SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL NULTY CRNA (PRESIDENT)
(336) 324-3116
Entity
Organization
Contact information
Practice address
1714 E HUNDRED RD STE 104, CHESTER, VA 23836-3310
(888) 209-0305
(952) 442-3620
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(888) 209-0305
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/09/2008
Last updated
12/10/2021
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