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MARY KATHLEEN HIDALGO CRNA

>> Nurse Anesthetist, Certified Registered >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1821199159

Individual Registrant:
 MARY KATHLEEN HIDALGO CRNA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3998 FAIR RIDGE DR SUITE 320 FAIRFAX, VA 22033-2907 US
Tel: 703-295-9360  Fax: 703-295-9369

Contact information for business:
500 HOSPITAL DR  WARRENTON, VA 20186-3027 US
Tel: 540-349-0514  Fax: --

Registration Information:
NPI: 1821199159
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
VA0024167953
N367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
AL1-101930
N367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
CO178681

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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