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General NPI Number Information
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NPI Number | 1508338351
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Entity Type | Individual
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Provider Name | COLIN WILLIAM HUSTED CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 1431 N CLAREMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60622-1702
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Country | US
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Telephone | 773-278-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 6343 N 52ND ST
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City | MANHATTAN
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State | KS
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Zip | 66503-9720
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 7117
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License Number State | NC
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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 | 041.429403
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License Number State | IL
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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 | 209019311
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License Number State | IL
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