Healthcare Provider Details

I. General information

NPI: 1295196624
Provider Name (Legal Business Name): ESTHER KIA HALLOCK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESTHER KIA WERBER CRNA

II. Dates (important events)

Enumeration Date: 03/12/2016
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

616 WILSON ST
ASHEVILLE NC
28803-2845
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-2671
  • Fax:
Mailing address:
  • Phone: 904-955-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6191
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number712114
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: