Healthcare Provider Details

I. General information

NPI: 1376968909
Provider Name (Legal Business Name): CHRIS HUMMEL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 15TH ST NW
NORTON VA
24273-1616
US

IV. Provider business mailing address

5209 SPOTSWOOD RD
NORTON VA
24273-4062
US

V. Phone/Fax

Practice location:
  • Phone: 276-439-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024171503
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: