Provider Demographics
NPI:1619543055
Name:LETHEON ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:LETHEON ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:985-665-6639
Mailing Address - Street 1:19041 TURNBERRY CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-6607
Mailing Address - Country:US
Mailing Address - Phone:985-665-6639
Mailing Address - Fax:
Practice Address - Street 1:9001 SUMMA AVE STE 346
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3779
Practice Address - Country:US
Practice Address - Phone:833-774-6352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty