Individual
DEANNA YVONNE HITCHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
Mailing address
2605 TIMBER RIDGE DR, DECATUR, IL 62521-9581
(217) 413-9399
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-309468
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209.007070041.309468
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R03386
MEDICARE PTAN
IL
Enumeration date
01/29/2008
Last updated
12/21/2021
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