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General NPI Number Information
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NPI Number | 1629344569
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Entity Type | Individual
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Provider Name | HEIDI LEANN HAGUE CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 353 FAIRMONT BLVD
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City | RAPID CITY
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State | SD
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Zip | 57701-7375
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Country | US
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Telephone | 605-755-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 353 FAIRMONT BLVD
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City | RAPID CITY
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State | SD
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Zip | 57701-7375
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Country | US
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Telephone | 605-755-1000
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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 | 4189
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License Number State | CA
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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 | R37464
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License Number State | ND
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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 | CR000774
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN.0991674-CRNA
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License Number State | CO
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