MEDICARE: MR. DAN MORGAN HESTER 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
1	367500000X	Certified Registered Nurse Anesthetist	RN153659	GA

General Provider Information

NPI Number	:	1427117746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAN MORGAN HESTER CRNA

Provider Business Mailing Address
First Line	:	4012 MULLIKIN RD
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-6901
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLD 300 DDEAMC
Second Line	:	ANESTHESIA
City	:	FT GORDON
State	:	GA
Zip	:	30905-5650
Country	:	US
Telephone Number	:	706-787-1910
Fax Number	:	706-787-7921

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/08/2007

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