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Individual

DAVID HOUZENGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
120 HOSPITAL DR, LEBANON, MO 65536-9238
(417) 533-6100
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2015027438
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
MEDICARE
MO
05
PENDING
AR
05
PENDING
MO
Enumeration date
08/16/2015
Last updated
01/16/2025
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