Organization
INDEP ANESTHESIA SERVICES OF LA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON WHITE CRNA (AUTHORIZED OFFICIAL)
(318) 675-7737
Entity
Organization
Contact information
Practice address
619 CALEDONIA DR, BOSSIER CITY, LA 71111-7131
(318) 675-7737
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
(847) 466-4358
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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