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General NPI Number Information
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NPI Number | 1851805402
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Entity Type | Individual
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Provider Name | ALICIA HERGES
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Gender | Female
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Dates
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Enumeration Date | 11/17/2017
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Last Update Date | 11/17/2017
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Provider Practice Location Address
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Address Line | 8383 N DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32514-6039
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Country | US
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Telephone | 850-494-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6538 QUAIL RUN DR
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City | PELHAM
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State | AL
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Zip | 35124-3106
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-122808
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License Number State | AL
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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 | RN9470416
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License Number State | FL
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