Organization
NURSE ANESTHESIA OF VIRGINIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN DALE HILLIARD (CFO)
(336) 899-1401
Entity
Organization
Contact information
Practice address
142 S MAIN ST, ANESTHESIA DEPT, DANVILLE, VA 24541-2922
(434) 799-2375
Mailing address
PO BOX 10824, BIRMINGHAM, AL 35202-0824
(205) 322-1808
(205) 322-1851
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053435388
—
VA
05
—
8000362
—
NC
Enumeration date
03/19/2007
Last updated
08/22/2008
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