Organization
PROVIDIAN ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENIS J BEITER CRNA (MEMBER)
(502) 472-5020
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY STE 400, LOUISVILLE, KY 40217-1412
(502) 276-5554
Mailing address
12468 LA GRANGE RD STE 342, LOUISVILLE, KY 40245-1901
(502) 472-5020
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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