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NPI Code Detail

MEDICARE: PAUL C HERGER CRNA

MEDICARE: PAUL C HERGER CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist0024152758VA
2367500000XCertified Registered Nurse AnesthetistAPN 781SC
3367500000XCertified Registered Nurse AnesthetistARNP 9168827FL
4367500000XCertified Registered Nurse AnesthetistREC # 017940NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417955212
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL C HERGER CRNA
Provider Business Mailing Address
First Line : 22 ELEMENTARY LN
Second Line :
City : PATRICK SPRINGS
State : VA
Zip : 24133-3714
Country : US
Telephone Number : 276-694-7745
Fax Number :
Provider Business Practice Location Address
First Line : 18688 JEB STUART HWY
Second Line :
City : STUART
State : VA
Zip : 24171-1559
Country : US
Telephone Number : 276-694-3151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 10/09/2009

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Directions to “ PAUL C HERGER CRNA” Practice Location

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