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NPI Code Detail

MEDICARE: TRAVIS HALLQUIST DNP, CRNA

MEDICARE: TRAVIS HALLQUIST DNP, 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
1163W00000XRegistered Nurse269177NC
2367500000XCertified Registered Nurse Anesthetist6378NC

General Provider Information

NPI Number : 1578187431
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRAVIS HALLQUIST DNP, CRNA
Provider Business Mailing Address
First Line : 1291 FRONT AVE UNIT 404
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-5278
Country : US
Telephone Number : 225-939-1982
Fax Number :
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 225-939-1982
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2020
Last Update Date : 01/20/2026

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