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General NPI Number Information
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NPI Number | 1215372446
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Entity Type | Individual
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Provider Name | TISHA HOOGENDOORN CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 1701 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-9907
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Country | US
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Telephone | 620-524-0799
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-9907
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Country | US
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Telephone | 620-524-0799
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1385318
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 147516
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 557206
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License Number State | KS
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