Basic Information
| Provider Information | |||||||||
| NPI: | 1770004871 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POINTE COUPEE ANESTHESIA TEAM LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4860 | ||||||||
| Address2: | |||||||||
| City: | MURRELLS INLET | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295762698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436512624 | ||||||||
| FaxNumber: | 8434914023 | ||||||||
| Practice Location | |||||||||
| Address1: | 14285 WATERLOO DR STE A | ||||||||
| Address2: | |||||||||
| City: | VENTRESS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707834104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257188302 | ||||||||
| FaxNumber: | 8434914023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2017 | ||||||||
| LastUpdateDate: | 06/29/2017 | ||||||||
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| AuthorizedOfficialLastName: | EAVES | ||||||||
| AuthorizedOfficialFirstName: | CHRISTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CRNA/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2257188302 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.