Healthcare Provider Details

I. General information

NPI: 1437156619
Provider Name (Legal Business Name): DANIEL DORN HIGNIGHT JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 HIGHWAY 411 N
ETOWAH TN
37331-1912
US

IV. Provider business mailing address

PO BOX 576
ATHENS TN
37371-0576
US

V. Phone/Fax

Practice location:
  • Phone: 423-263-9968
  • Fax: 423-263-9910
Mailing address:
  • Phone: 865-776-6464
  • Fax: 423-263-9910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN10151
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: