MEDICARE: DIANA CAROL HYDEN CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN 145755 / 03616NA	OH
2	367500000X	Certified Registered Nurse Anesthetist	1069935APRN3001677	KY
3	367500000X	Certified Registered Nurse Anesthetist	ARNP2597102	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093813529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA CAROL HYDEN CRNA

Provider Business Mailing Address
First Line	:	1352 NEW FOREST LN
Second Line	:
City	:	OSPREY
State	:	FL
Zip	:	34229-6845
Country	:	US
Telephone Number	:	941-266-2146
Fax Number	:

Provider Business Practice Location Address
First Line	:	9275 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-7779
Country	:	US
Telephone Number	:	941-266-2146
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	04/19/2016

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Directions to “ DIANA CAROL HYDEN CRNA” Practice Location

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