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General NPI Number Information
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NPI Number | 1578631560
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Entity Type | Individual
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Provider Name | LORI A HANEGAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 2025 MORSE AVE ANESTHESIA DEPARTMENT
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City | SACRAMENTO
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State | CA
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Zip | 95825-2115
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Country | US
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Telephone | 916-973-7705
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Fax |
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Provider Business Mailing Address
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Address Line | 3308 CAMELOT CT
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City | ROCKLIN
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State | CA
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Zip | 95765-5017
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Country | US
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Telephone | 916-435-5214
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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 | 2968
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License Number State | CA
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