Provider Demographics
NPI:1366849465
Name:SL ANESTHESIA
Entity type:Organization
Organization Name:SL ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP, FNP-C, CRNA
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LESUEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-893-2463
Mailing Address - Street 1:445 E 200 S STE 140
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2143
Mailing Address - Country:US
Mailing Address - Phone:801-893-2363
Mailing Address - Fax:
Practice Address - Street 1:445 E 200 S STE 140
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2143
Practice Address - Country:US
Practice Address - Phone:801-893-2463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5188629-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty