Provider Demographics
NPI:1316305519
Name:QUALITY SLEEP ANESTHESIA P.C.
Entity type:Organization
Organization Name:QUALITY SLEEP ANESTHESIA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEBEKER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:208-569-5818
Mailing Address - Street 1:3155 CHANNING WAY STE A
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7534
Mailing Address - Country:US
Mailing Address - Phone:208-569-5818
Mailing Address - Fax:
Practice Address - Street 1:3155 CHANNING WAY STE A
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404
Practice Address - Country:US
Practice Address - Phone:208-569-5818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA382A261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain