Healthcare Provider Details

I. General information

NPI: 1760401897
Provider Name (Legal Business Name): ANDREW J HUNSINGER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDY J HUNSINGER

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 JEFFERSON ST
PELLA IA
50219-1257
US

IV. Provider business mailing address

PO BOX 688
PELLA IA
50219-0688
US

V. Phone/Fax

Practice location:
  • Phone: 641-628-6634
  • Fax: 641-621-2458
Mailing address:
  • Phone: 816-461-8288
  • Fax: 816-461-6586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number054429
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD107495
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: