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General NPI Number Information
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NPI Number | 1790795425
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Entity Type | Individual
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Provider Name | CRAIG HITCHCOCK CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 48 W 1500 N
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City | NEPHI
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State | UT
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Zip | 84648-8900
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Country | US
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Telephone | 435-623-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3810
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City | SALT LAKE CITY
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State | UT
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Zip | 84110-3810
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Country | US
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Telephone | 5-946-3998
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Fax | 801-676-5961
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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 | 2123774406
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License Number State | UT
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